左半结肠癌伴肠梗阻患者支架置入后的短期疗效分析

Analysis of Short-Term Efficacy after Stent Placement in Patients with Left-Sided Colon Cancer Complicated by Intestinal Obstruction

摘要: 目的：研究左半结肠癌伴肠梗阻患者肠道支架置入后的短期疗效。方法：采用回顾性队列研究方法，纳入重庆医科大学附属第二医院2015-01至2019-08期间确诊收治左半结肠癌伴肠梗阻手术的患者，分析左半结肠癌伴肠梗阻患者置入肠道支架后限期手术的短期疗效，主要终点为术后并发症发生率，次要终点为术中淋巴结清扫数目、肠造口率、术中失血量、术后感染指标、术后住院时间等。结果：共收集111名患者，分别为支架组41例，急诊组70例。两组在术后并发症发生率方面，支架组明显少于急诊组(P < 0.05)，且支架组在术后住院时间、术中淋巴结清扫数目、肠造口率、术中失血量、术后感染指标方面同样优于急诊组(P < 0.05)。结论：左半结肠癌伴梗阻患者行支架置入后可及时缓解肠梗阻症状，并可行腹腔镜一期切除吻合，与急诊开腹手术相比，术后并发症发生率明显减少。

Abstract: Objective: To investigate the short-term efficacy of intestinal stent placement in patients with left-sided colon cancer complicated by intestinal obstruction. Methods: A retrospective cohort study was conducted, including patients diagnosed and treated for left-sided colon cancer with intestinal obstruction at The Second Affiliated Hospital of Chongqing Medical University from January 2015 to August 2019. The short-term outcomes of elective surgery after intestinal stent placement in patients with left-sided colon cancer complicated by intestinal obstruction were analyzed. The primary endpoint was the incidence of postoperative complications, and secondary endpoints included the number of intraoperatively dissected lymph nodes, stoma formation rate, intraoperative blood loss, postoperative infection markers, and postoperative hospital stay. Results: A total of 111 patients were included, comprising 41 cases in the stent group and 70 cases in the emergency surgery group. In terms of the incidence of postoperative complications between the two groups, the stent group demonstrated significantly lower postoperative complication rates compared to the emergency group (P < 0.05). Additionally, the stent group showed advantages over the emergency group in postoperative hospital stay, number of lymph nodes dissected, stoma formation rate, intraoperative blood loss, and postoperative infection markers (P < 0.05). Conclusion: Stent placement in patients with left-sided colon cancer complicated by obstruction effectively alleviates intestinal obstruction symptoms and enables subsequent laparoscopic primary resection and anastomosis. Compared to emergency laparotomy, this approach significantly reduces postoperative complication rates.