脾屈曲肿瘤次全结肠切除术的短期疗效:单中心研究

M. Aslan, Oktay Karakose
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摘要

脾屈性肿瘤是结肠肿瘤的一种亚型,其治疗方法仍有争议。我们的目的是评估手术方法和短期预后的脾脏屈曲肿瘤。回顾性分析了2017年8月至2020年3月在三星培训研究医院外科肿瘤科接受结肠次全切除术的14例脾屈或脾屈附近结肠肿瘤患者的术后发病率、死亡率和早期肿瘤预后。在评估的14名患者中,12名是紧急的,2名是选择性的。4例患者接受了额外的器官切除作为治疗手术。所有患者病理均为结肠腺癌,5例(35.7%)为黏液型。淋巴结阳性6例(42.8%),转移1例(7.1%)。术后2例(14.2%)发生手术部位感染,1例(7.1%)死亡。8例(57.1%)患者排便更频繁,平均排便次数为3±1.6次/天。根据我们的临床经验,结肠次全切除术适用于脾屈曲肿瘤的紧急手术治疗,而左结肠切除术适用于选择性条件。
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Short-term outcomes of subtotal colectomy for splenic flexure tumors: a single-center experience
Splenic flexure tumors are a subtype of colon tumors whose treatment is still debated. We aim to evaluate the surgical methods and short-term outcomes of splenic flexure tumors. Fourteen patients with colonic tumors at or near the splenic flexure who underwent subtotal colectomy in the surgical oncology department of Samsun Training and Research Hospital between August 2017 and March 2020 were retrospectively evaluated in terms of postoperative morbidity, mortality, and early oncologic outcomes. Of the fourteen patients evaluated, twelve were urgent and two were elective. Four patients underwent additional organ resection as a curative surgery. The pathology was colonic adenocarcinoma in all patients, and the histotype was mucinous in five patients (35.7%). Lymph node positivity was detected in six patients (42.8%) and metastasis in one patient (7.1%). Postoperatively, two patients (14.2%) developed surgical site infection, and one patient (7.1%) died. Eight (57.1%) patients complained of more frequent defecation, with a mean bowel movement frequency of 3±1.6 times daily. Based on our clinical experience, subtotal colectomy is appropriate for emergency surgical treatment of splenic flexure tumors, whereas left hemicolectomy is appropriate under elective conditions.
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