Surgical Analysis Of Acute Obstructed Splenic Flexure Tumors By Extended Right Colectomy

Objective To analyze the effect of acute obstructed splenic flexure tumors by extended right colon resection.Methods Of the 22 patients diagnosed as splenic flexure tumors at the second hospital of Jilin University in 2015.6-2017.6,the data of 9 cases of acute obstructed splenic flexure tumors for extended right colon resection were reviewed.All the 9 patients were diagnosed as splenic flexor tumor with intestinal obstruction before operation,and no distant metastasis of the liver and lungs were found.Before the routine preoperative examination,the necessary preoperative correction and treatment were performed.In 48 hours,9 patients were treated with an emergency laparotomy,which was proved to be a colonic splenic flexor tumor in the operation.The radical operation of right colon was used in the operation,and the pathological result was postoperative adenocarcinoma.The indexes were as follows: sex,age,body mass index,operation time,hospitalization time,postoperative mortality,anastomotic fistula,anastomotic bleeding,pulmonary infection,abdominal infection,heart failure,acute renal failure,incisional infection,the maximum diameter of the tumor,TNM staging,the number of lymph nodes excised,and the resection of intestinal canal.Length,postoperative first exhaust time,postoperative 3 month and 6 month defecation frequency,postoperative recurrence.Results A total of 9 patients were included in the observation,including 5 men and 4 women.The mean age was 62.3 +12.0 years,with an average of BMI 24.3 + 4.1 kg/m2,mean operative time 123.0 + 22.5 min,and average length of stay 16.3 + 2.0 d.No patient died after operation,anastomotic leakage and anastomotic bleeding did not occur,and no patient developed abdominal infection.All patients were cured and discharged.The mean diameter of tumor was 5.7 + 2.4 cm,and the average number of lymph nodes removed 23.3 + 7.4 was average.The average length of bowel resection was 49.5+ 13.4 cm.The postoperative first exhaust time was 4.22 + 1.1 days.All patients were followed up by telephone and outpatient review,and no patients were lost.During the 6 month follow-up,the average number of defecation was 3.0 + 1.1 times in third months after operation,and the average number of defecation was 2.0 + 0.7 times in sixth months after operation.In only 1 cases,the number of defecation times increased.Through the adjustment of food structure and the use of intermittent antidiarrheal,the number of defecation was 2-3 times per day,and no recurrence was found in the 3-6 months after the operation.Conclusion For the patients with acute obstruction of the splenic flexure tumors,it is a safe and effective operation to extended right colectomy.This method can not only achieve the purpose of radical resection of the tumor and the first stage of intestinal anastomosis,but also avoid intestinal stomatostomy and two stomatostomy.