Hartmann术式和支架植入手术切除一期吻合术式治疗左半结肠癌并肠梗阻临床对比研究

Clinical comparative research between Hartmann operation and stent implantation excision primary anastomosis operation in the treatment of left hemicolon carcinoma complicated with intestinal obstruction

目的探讨Hartmann术式和支架植入手术切除一期吻合术式治疗左半结肠癌并肠梗阻的临床疗效差异。方法 150例左半结肠癌并肠梗阻患者随机分为对照组和观察组,各75例,分别采用Hartmann术式和支架植入手术切除一期吻合术式治疗,比较两组患者临床受益评分,术后肛门排气时间、住院时间、术后并发症发生情况、术后转移率及5年生存率等。结果观察组患者临床受益评分显著高于对照组,差异有统计学意义(P<0.05);观察组患者住院时间显著短于对照组,差异有统计学意义(P<0.05);两组患者术后肛门排气时间、并发症发生率比较差异无统计学意义(P>0.05);观察组患者术后转移率显著低于对照组,差异有统计学意义(P<0.05);两组患者5年生存率比较差异无统计学意义(P>0.05)。结论支架植入手术切除一期吻合术式治疗左半结肠癌并肠梗阻可有效提高临床受益评分,加快术后康复进程,并降低术后转移风险,疗效优于Hartmann术式。

Objective To investigate clinical effect differences between Hartmann operation and stent implantation excision primary anastomosis operation in the treatment of left hemicolon carcinoma complicated with intestinal obstruction. Methods A total of 150 patients with left hemicolon carcinoma complicated with intestinal obstruction were randomly divided into control group and observation group, with 75 cases in each group. Hartmann operation and stent implantation excision primary anastomosis operation were applied respectively in the two groups, and comparisons were made on clinical benefit scores, postoperative anal exhaust times, hospital stays, postoperative complications, postoperative metastasis rate, and survival rate in 5 years. Results The observation group had higher clinical benefit scores than the control group, and the difference had statistical significance（P〈0.05）. The observation group had shorter hospital stays than the control group, and the difference had statistical significance（P〈0.05）. There was no statistically significant difference of incidence of postoperative anal exhaust times and complications between the two groups（P〉0.05）. The postoperative metastasis rate was obviously lower in the observation group than in the control group, and the difference was statistically significant（P〈0.05）. The difference of survival rate in 5 years between the two groups had no statistical significance（P〉0.05）. Conclusion Application of stent implantation excision primary anastomosis operation in treating left hemicolon carcinoma complicated with intestinal obstruction can effectively improve clinical benefit scores, enhance postoperative rehabilitation process, and reduce risk of postoperative metastasis. It has better curative effect than Hartmann operation