本院自1996年9月至1998年3月共收治大肠癌患者21例,占同期肿瘤患者住院总数的2.1%,位于食管癌、贲门癌、乳腺癌后居第4位。21例均经外科治疗,其中有16例直肠痛、5例结肠痛。年龄最大72岁,最小26岁,平均53岁,男女比例为7:14,手术切除率100%,行结肠腹壁造瘘切除肛管者12例,9例行腹腔内结肠、直肠吻合术。术后1例发生会阴切口延期愈合,2例发生切口感染,1例造瘘口肠管坏死,并发症发生率19%。大肠癌患者人院临床症状较明显,经过积极的术前准备能够提高手术切除率、避免感染,术中严格的无菌、无瘤操作亦是关键步骤。直肠癌肛管切除后,要用大量的温盐水经腹腔冲洗盆腔,使液体从会阴部切口流出,冲掉手术时可能播散于创面上的癌细胞及其它异物,再彻底止血,于骶前放置橡皮管负压引流,术后要经常以盐水或甲硝唑注射液冲洗引流管,排除血凝块,保持引流通畅,术后5~7d引流基本消失时再拔除引流管。保持骶前引流通畅是保证会阴切口早期愈合的关键因素。另1例于术后第5天出现肠梗阻,经检查发现造瘘口肠管缺血坏死,经2次手术治愈。术中发现腹外斜肌腱膜瘘口过小,压迫肠管造成供血不足及排气受阻,经切开扩大后重新造瘘成功。术后10d痊愈出院。 In this hospital from September 1996 to March 1998 a total of 21 patients with colorectal cancer, accounting for 2.1% of the total number of hospitalized cancer patients in the same period, located in esophageal, cardiac cancer, breast cancer after the fourth. All 21 cases were treated with surgery, including 16 cases of rectal pain and 5 cases of colon pain. The oldest was 72 years old, the youngest was 26 years old, and the average was 53 years old. The ratio of males and females was 7:14. The resection rate was 100%. There were 12 cases of colon resection for anal fistula and 9 cases of intra-abdominal colon and rectal anastomosis. In one case, delayed healing of the perineal incision occurred, incision infection occurred in 2 cases, and fistula in 1 case had necrosis of the intestine. The complication rate was 19%. Patients with colorectal cancer have obvious clinical symptoms. After active preoperative preparation, they can improve the resection rate and avoid infection. The strict aseptic and tumor-free operation is also a key step in the operation. After anal resection of rectal cancer, a large amount of warm saline is used to wash the pelvic cavity through the abdominal cavity, so that the liquid flows out from the perineal incision, and the cancer cells and other foreign substances that may spread on the wound during surgery may be flushed, and the hemostasis is completely stopped. Place a negative pressure drainage of the rubber tube. After the operation, the drainage tube should be flushed with saline or metronidazole injection. The blood clot should be excluded and the drainage should be maintained. The drainage tube should be removed when the drainage disappeared after 5 to 7 days. Maintaining patency of the anterior iliac crest is a key factor in ensuring early healing of the perineal incision. In the other case, intestinal obstruction occurred on the fifth day after operation. After examination, it was found that the intestine fistula was an ischemic necrosis and was cured by two operations. During the operation, the diaphragm of the external oblique muscle was found to be too small and the intestine was compressed, resulting in insufficient blood supply and obstruction of the exhaust. After resection, the hernia was successfully reconstructed. After 10 days, he was discharged from the hospital.