结肠腔内置管在梗阻性左半结肠癌中的应用

目的 探讨预防梗阻性左半结肠癌一期切除吻合术后吻合口漏发生的新方法，方法 将２１５例便阻性左半结肠癌术中结肠灌洗和一期切除吻合等处理的患者随机分为两组。双管引流组术中经肛门旋转结肠腔内双管引流，扩肛组术中不旋转肠腔内引流管，术后定时扩肛，对两组患者术后腹腔脓肿和吻合口漏发生率进行对比分析。结果 腹腔脓肿和吻合口漏发生率双管引流组分别为３．１％（４／１３０）和３．８％（５／１３０），扩肛组分别为１０

Effect of drainage with double tubes througth anus on emergent left colon resection with primary anastomo for obstructingcarcinoma ofthe leftcolon

Objective To investigate the new methods of preventing anastomotic leakage after emergent left colon resection with primary anastomosis for obstructing carcinoma of the left colon.Methods 215 patients with obstructing carcinoma of the left colon were allocated to two groups, each underwent emergent left colon resection with primary anastomosis and on-table colonic irrigation. In the drain age group, two tubes were placed proximal and distal to the anastomosis in the colonic cavity. Patients of the control group only received anal dilation regularly without the two tubes drainage. The postoperative complications of two grpups were compared.Results There were 9(10.6%) intra-abdominal abscess and 11(12 9%) anastomotic leaks in the control group. In the drain group, 4(3 1%) intra-abdominal abscess and 5(3 8%) anastomotic leaks occurred. The incidence of intra-abdominal abscess and anastomotic leak in the control group were significantly higher than that in the drain group( P <0 05).Conclusion Drainage by two tubes in the colonic cavioty can effectively prevent anastomotic leak after emergent resection of left colon with primary anastomosis for obstructing carcinoma of the left colon.