目的 :探讨无周围器官浸润的中上段直肠癌所致急性肠梗阻应用一期切除吻合术的安全性。方法 :回顾 1 996 2 0 0 3年间1 7例行一期切除吻合的无周围器官浸润的中上段直肠癌致急性梗阻病例。平均年龄 6 4 2岁 ,均行术中顺行结肠灌洗。结果 :术后切口感染 3例 (1 7 6 % ) ,肺部感染 1例 (5 9% )并致呼吸衰竭死亡 ,吻合口瘘 2例 (1 1 7% ) ,1例保守治疗治愈 ,另一例切开预防性造口后痊愈。结论 :对无周围器官浸润的中上段直肠癌所致急性肠梗阻应争取实施一期切除吻合术 ;在术中顺行结肠灌洗等措施下 ,手术的安全性是有保障的 Objective: To investigate the safety of primary resection and anastomosis in the treatment of acute intestinal obstruction caused by middle and upper rectal cancer without peripheral organ infiltration. Methods: A retrospective study of 17 cases with acute obstruction in the upper and middle rectal cancers without peri-organ infiltrating in 17 cases who underwent primary resection and anastomosis between 1996 and 2003 was performed. The average age of 642 years old, were performed intraoperative colonic lavage. Results: Three cases (176%) were infected with incision and one case (59%) with lung infection. Respiratory failure resulted in 2 cases of anastomotic fistula (11.7%) and 1 case was cured by conservative treatment. A case of incision cured after stomatology cured. Conclusion: Acute intestinal obstruction caused by upper and middle rectal cancer without infiltration of peripheral organs should strive for implementation of a one-stage resection and anastomosis. Under the circumstance of colonic lavage, the safety of operation is guaranteed