Left Colon Surgical Treatment Of Patients With Acute Intestinal Obstruction-A Retrospective Analysis Of109Patients

Objective: Retrospective analysis of left colon cancer with acute obstruction underwentI combined total colonic lavage group,I resection and anastomosis,I resection combinedcolostomy group, Hartmann,I of proximal colostomy,â…¡of resection surgery.Discussionwith acute obstruction of left colon surgically and I stage resection combined with allcolonic Lavage of the safety and feasibility.Method: Review of the First Affiliated Hospital of Fujian Medical University from2007January to2014January in109cases left colon with acute intestinal obstruction data.â… resection and anastomosis in41cases, I combined total colonic lavage group of21cases,â… resection combined colostomy group in31cases, Hartmann in7cases,â… of proximalcolostomy,â…¡of resection surgery in9patients.Comparisonâ… resection and anastomosis,â… combined total colonic lavage group,â… resection combined colostomy group, threegroups of postoperative anastomotic leakage rates, surgical infection (including incision,abdominal infection rate), the average operation time, blood loss, hospital costs, length ofhospital stay and recovery of gastrointestinal function.Conclusions: The group of109cases,106cases were cured,3patients died. Themortality is2.75%. Pathology:In highly differentiated adenocarcinoma95cases,Lowdifferentiated adenocarcinoma5cases,Mucinous adenocarcinoma9cases. Staging:stageâ… 95, stageâ…¡49cases, stage â…¢31cases, stage â…£22cases. The lavage group incisioninfection2cases, Anastomotic fistula1cases,no abdominal infection occurred. Resectionand anastomosis incision infection5cases,Anastomotic fistula4cases,Abdominal infection3cases,â… resection combined colostomy group incision infection7cases,Anastomoticfistula2cases,Abdominal infection2cases.Incision infection after local drainage, dressing,physiotherapy;Anastomotic fistula after partial double cannula drainage, fasting, gastrointestinal decompression, anti-inflammation and total parenteral nutrition supportafter the healing;Abdominal infection were cured by peritoneal lavage and drainage.Allcases after12to40days were cured.Three groups of patients with clinicopathologicfeatures, operation bleeding, abdominal infection rate, peritoneal tube removal time had nosignificant difference (P>0.05).The anastomotic leakage, wound infection, discharge time,eating time, unplug the stomach tube time, hospital stay, hospital costs were significantlylower inâ… stage resection combined with total colonic lavage group than that inâ… resectionand anastomosis. The difference was statistically significance (P<0.05). The woundinfection, length of stay, hospital costs were significantly lower inâ… stage resectioncombined with total colonic lavage group than that inâ… resection combined colostomygroup. The difference was statistically significant (P <0.05).Results: Operation mode of colon cancer with acute intestinal obstruction should beselected individually, the premise of strict indications, postoperative efficientbroad-spectrum antibiotics application in selecting cases,â… resection and anastomosiscombined with total colon lavage in the treatment of left colon cancer with acute intestinalobstruction is safe and effective feasible,To avoid2operation, faster recovery, shorterhospital stay, hospital costs less, lower complication rate.but for general condition is poor,severe peritonitis, more complications, heart and lung and other organs dysfunction, loss ofintestinal vitality,first considering the lifting of obstruction, saving lives,The best surgeryof Hartmann,s orâ… of proximal colostomy,â…¡of resection surgery.