Treatment of acute obstructive cased by colorectal cancer / 国际外科学杂志

ABSTRACT

Objective To investigate the treatment of acute obstructive colorectal cancer.Methods The clinical data of 26 cases with acute obstructive colorectal cancer were analysed retrospectively and relevant literatures were reviewed.Results Radical right hemicolectomy was performed in 9 patients with obstructive right colonic cancer.Among 17 patients with obstructive left colorectal cancer,one-stage radical resection was perfomed in 12 cases,including one-stage anastomosis in 4 cases and Hartmann's operation in 8 cases.Palliative colostomy was performed in 3 cases.Right hemicolectomy and sigmoid colon loop colostomy was performed in 1 case of rectum cancer with ascending colon strangulation.One case refused surgery.Two cases died of MODS and 1 case with inflammatory ileus recovering from conservative treatment after operation.In the course of disease,septic shock and MODS happened in 3 cases,lung infection in 5 cases,heart disease in 2 cases and Hypoalbuminemia in 16 cases.Conclusions One-stage radical colectomy and anastomosis should be performed in patients with obstructive right colonic cancer.In order to reduce toxin absorption and prevent the deterioration of disease,Bowel decompression and removal of inflammatory exudate should be performed in patients with obstructive left colorectal cancer according to the damage control theory.Then effective and safe operation should be chosen in accordance with patients' status.Anti-infection and nutrition support treatment must be strengthened after operation.