Résumé
Objective To exprole the effect of surgical management of obstructive colorectal carcinoma. Methods A restrospective analysis was made on the clinical data of 76 cases of acute obstructive colorectal carcinoma treated by emergent operation in Xiangya Hospital from October 1997 to October 2002.Among the 76 cases,there were 23 cases of right colon obstruction and 53 cases of left colon or rectal obstruction. Results All the 76 patients received opreation , 55 patients received one stage tumor resection and large intestinal anastomosis, including 19 in right colon and 36 in left colon or rectal obstruetion.Postoperative complications rate was 15.7%(11/76) in this series,including anastomotic leakage in 2, disruption of wound in 1, infection of incisional wound in 6, and pneumonia in 2.Expect one patient died of MSOF,the others were curred by non-operation therapy.The postoperative 1,3,5year survival rate was 98.3%,55%,38.5% in this series.Conclusions One stage resection and anastomosis is a feasible operation for obstructive colorectal carcinoma.Appropriate choice of the operative procedure, skillful operative technique,and prudential perioperative treatment can enhance the cuerative effect and the patients quality of life.
Résumé
ObjectiveTo determine the principle and method of surgical management of acute colon obstruction caused by carcinoma in the elder patients. MethodsClinical data of 98 patients with acute colon obstruction caused by carcinoma were analyzed retrospectively. ResultsOf 98 patients undergoing operation,complications occurred in 8 cases,and 3 ( 3.1%)died postoperatively.The other patients were healed. ConclusionsThe management of acute colon obstruction caused by carcinoma in the elder patients depends on the patients,general condition and local condition of the carcinoma.If it is an indication, one-stage resection of the cancer and anastomosis of the colon may be safe and suitable .
Résumé
Objective To study the surgical treatment principles of obstructive colorectal cancer. Methods The clinical data of 108 cases of obstructive colorectal cancer treated in our hospital in recent 10 years were retrospectively analysed. Of 30 cases of right hemicolon cancer ,28 cases received primary hemicolectomy and anastomosis,1 underwere conversative operation,and 1 received non-operative treatment.In 78 patients with left hemicolon or rectal cancer,56 underwent primary resection ( primary and secondary anastomosis were performed on 32 and 24 cases, respectively), and 11 received two-stage resection;nonresectable cancer underwent by-pass procedures in 6 cases,and non-operative treatment in 5. Results Most obstructive colorectal cancer were moderate or poor differentiated adenocarcinoma (65 cases) and in Dukes C or D stages(59 cases) . Postoperative complications rate was 27.3%(26 cases,46 times),most were infective complications(35/46) including 4 cases of anastomotic leakage. Eight cases died during perioperative period. The 5-year survavil rate in operative and nonoperative cases was 28.4% and 0% respectively(P0.05). Conclusions The surgical treatment principles for patients with obstructive colorectal cancer is to remove the tumor and relief the obstruction by one-stage operation individually if possible.But one-or two-stage anastomosis after tumor resection seems to be no influence on the patients prognosis.
Résumé
Objective To study the surgical managements for obstructive coleratal carcinoma(OCRC).(Methods) Clinical data of 126 patients with OCRC who underwent surgical treatment between January 1995 and December 2004 were reviewed.Results Thirty-five patients received one-stage right hemicolectomy,ten patients received one-stage resection of transverse colon.forty-eight patients received one-stage left(hemicolectomy),eighteen patients received one-stage resection of left colon or proximal rectum with colostomy followed by two-staged anastomosis.For 15 patients with unresectable lesions,colostomy of transverse colon or sigmoid colon was performed.Seventeen patients(13.5%) experienced postoperative complications.The (operative) mortality was 4.8%(6/126).The 1-year,3-year and 5-year overall survival rate was(95.1)%,52.7% and 38.1%,respectively.Conclusions Proper perioperative period managements and(selection) of surgical techniques are important for better results and lower complications in the treatment OCRC.