术前经肛间断低负压冲洗引流治疗结直肠癌合并肠梗阻的效果

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1840 KB) RICH HTML
输出: BibTeX | EndNote (RIS)

摘要目的探讨术前经肛间断低负压冲洗引流治疗结直肠癌合并肠梗阻的效果。方法选择武警总医院2010-01至2017-03收治的23例梗阻性结直肠癌,术前经肛置入结肠梗阻管,行低负压间断冲洗引流2周,然后手术切除病灶。收集结肠冲洗前后的腹部CT、术中所见、术后并发症、住院时间、住院费用。结果本组均成功完成结肠减压。其中,13例肠梗阻当天缓解,10例3 d后缓解。5例结肠冲洗后行CT检查,可见梗阻缓解,肠腔管径恢复正常。术中见肠管无扩张、肠壁基本正常。本组均完成手术,术后伤口感染2例,无术后吻合口瘘,术后住院时间平均(14.5±6.7)d,住院费用(11.3±2.7)万元。结论梗阻性结直肠癌术前行间断低负压冲洗引流术,可以有效地完成经肛结肠减压、肠道清洁和肠道营养,为一期腹腔镜结直肠癌切除术创造良好条件。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	周腾
	郑皓
	达布·西力特
	蔡晓军
	贾元利
	韩承新

关键词 ：结肠减压, 结直肠癌, 肠梗阻

Abstract：Objective To investigate the effect of preoperative low negative pressure irrigation and drainage through the anorectal interval for colorectal cancer complicated with intestinal obstruction.Methods Twenty-three cases of obstructive colorectal carcinoma treated in our hospital between January 2010 and March 2017 were selected as subjects. Before operation, the colonic obstruction tube was placed through the anus. Then, the focus was resected by low negative pressure lavation and drainage for two weeks. Abdominal CT before and after colonic lavage, intraoperative findings, postoperative complications, length of hospital stay and expenses were analyzed.Results Colon decompression was completed successfully in all the patients. Among them, 13 cases of intestinal obstruction were relieved on the same day and 10 cases were relieved after 3 days. CT examination was performed in 5 cases after colonic lavage. Obstruction was relieved and the intestinal lumen diameter returned to normal. No dilation of the intestinal canal and normal wall was observed during operation. There were 2 cases of postoperative wound infection, but no anastomotic fistula occurred. The average length of hospital stay was (14.5±6.7)days, and the cost of hospitalization was (113,000±27,000) yuan.Conclusions Intermittently low negative pressure irrigation and drainage can effectively perform transanal colon decompression, intestinal cleaning and nutrition, which creates good conditions for one-stage laparoscopic resection of colorectal carcinoma.

Key words： colonic decompression colorectal cancer intestinal obstruction

收稿日期: 2018-02-10

ZTFLH:	R656.9
	R657.1

基金资助:首都医学发展科研基金(WZ2015028)

通讯作者: 韩承新,E-mail: hcxhyfhq@sina,com

作者简介: 周腾,硕士研究生,医师。

引用本文:

周腾, 郑皓, 达布·西力特, 蔡晓军, 贾元利, 韩承新. 术前经肛间断低负压冲洗引流治疗结直肠癌合并肠梗阻的效果[J]. 武警医学, 2018, 29(9): 892-894. ZHOU Teng, ZHENG Hao, DABU Xilite, CAI Xiaojun, JIA Yuanli, and HAN Chengxin.. Preoperative treatment of obstruction caused by colorectal cancer via transanal discontinuous suction at low negative pressure. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(9): 892-894.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2018/V29/I9/892

[1]	中华人民共和国卫生和计划生育委员会医政医管局. 结直肠癌诊疗规范(2015年版)[J]. 中华外科杂志, 2015, 53(12):1177-1191.
[2]	石田康男,幡谷洁,樱井修,等.肠梗阻导管经肛门引流新疗法[J].腹部急救诊疗进步,1999,19(1):35-37.
[3]	姚礼庆,钟芸诗,许剑民,等.经肠镜导管减压术在急性低位结直肠梗阻中的应用[J].中华消化内镜杂志,2006,23(5):325-328.
[4]	姚宏伟,傅卫,袁烔,等.经肛肠梗阻导管治疗急性左半结肠恶性梗阻性疾病的临床研究[J].中国微创外科杂志,2006,6(12):941-943.
[5]	周创业.经肛肠梗阻导管及肠内营养在急性梗阻性结直肠癌中的应用[D]. 天津:天津医科大学,2012.
[6]	许剑民,钟芸诗,徐美东,等.经肛型肠梗阻减压导管在急性低位结肠梗阻中的应用[J]. 中华胃肠外科杂志, 2006, 9(4): 308-310.
[7]	Hotta T, Takifuji K, Kobayashi Y, et al. Management of obstructive colorectal cancer: evaluation of preoperative bowel decompression using ileus tube drainage[J]. Surg Today, 2012,42(12): 1154-1164.
[8]	Shingu Y, Hasegawa H, Sakamoto E, et al. Clinical and oncologic safety of laparoscopic surgery for obstructive left colorectal cancer following transanal endoscopic tube decompression[J]. Surg Endosc, 2013, 27(9): 3359-3363.
[9]	苗鹏,张光哲,舒强. 经肛肠梗阻导管在左半结肠癌性肠梗阻患者腹腔镜手术前的应用[J].中华普外科手术学杂志(电子版),2015,9(2):118-120.
[10]	牟一平, 杨鹏, 严加费,等. 腹腔镜结肠癌根治术的临床疗效评估[J]. 中华外科杂志, 2006, 44(9): 581-583.
[11]	Champault G G, Barrat C, Raselli R, et al. Laparoscopic versus open surgery for colorectal carcinoma: a prospective clinical trial involving 157 cases with a mean follow-up of 5 years[J]. Surg Laparosc Endosc Percutan Tech, 2002, 12(12):88-95.