老年大肠癌致肠梗阻的围术期处理和手术疗效分析

目的探讨老年大肠癌致肠梗阻患者的围术期处理方法和手术疗效。方法对80例老年大肠癌致梗阻患者行手术治疗。结果80例患者中25例行一期右半结肠切除,10例行一期横结肠切除,30例行一期左半结肠切除,10例行一期左半结肠或直肠上段切除、近端结肠造瘘,关闭远端结肠或直肠备做二期切除,5例肿瘤无法切除行乙状结肠或横结肠造瘘。术后并发症发生率12.5%(10/80),围术期病死率2.5%(2/80);随访统计1、3、5年生存率分别为93.8%、54.3%和37.5%。结论术前对有伴发疾病的老年大肠癌致肠梗阻患者认真进行评估和处理,正确选择手术时机和采取合理的手术方式能获得良好的预后。

Perioperative Features and Results of Surgical Treatment of Obstructive Colorectal Carcinoma in Aged

Objective To investigate perioperative features and results of surgical treatment of Ostructive Clorectal Crcinoma(OCRC)in aged.Methods We reviewed the clinical data of 80 aged patients with OCRC who underwent surgical treatment from July 1998 to July 2005.Results Twenty-five patients received first-stage right hemicolectomy ;ten patients received first-stage resection of transverse colon.Thirty patients were treated with first-stage left hemicolectomy; Ten patients with first-stage resection of left colon or proximal rectum colostormy followed by second-staged anastomosis.For five patients with unresectable lesions,colostomy of transverse colon or sigmoid colon was performed.Ten patients (12.5%) experienced postoperative complications.The operative mortality was 2.5%(2/80).The survival rates of 1 year,3 year and 5 year were respectively 93.8%,54.3% and 37.5%.Conclusion Good prognosis can be obtained if we choose correct opportunity and rational method of operation.