内镜下支架置入联合择期手术在梗阻性结直肠癌中的应用

Endoscopic Stent Implantation Combined with Elective Surgery in Application of Obstructive Colorectal Cancer

目的探讨内镜下支架置入联合择期手术在梗阻性结直肠癌中的应用价值。方法对2015年2月—2017年5月收治的梗阻性结直肠癌96例的临床资料进行回顾性分析,根据手术方法分为对照组及观察组,每组48例。观察组给予经内镜下置入金属支架联合择期手术,对照组行急诊手术治疗。比较2组一期切除吻合率、手术时间、术后通气时间、住院时间、并发症发生率和住院期间病死率。结果观察组一期切除吻合率高于对照组,手术时间、术后通气时间短于对照组(P<0.05,P<0.01),但2组住院时间比较差异无统计学意义(P>0.05)。观察组术后并发症发生率低于对照组(P<0.01)。观察组无一例死亡,对照组死亡2例。结论内镜下支架置入联合择期手术治疗梗阻性结直肠癌安全性更高,且增加一期切口吻合率,并减少并发症,可作为梗阻性结直肠癌的有效治疗方法。

Objective To investigate value of endoscopic stent implantation with elective surgery in application of patients with obstructive colorectal cancer. Methods Clinical data of 96 patients with obstructive colorectal cancer admitted during February 2015 and May 2017 was retrospectively analyzed, and the patients were divided into control group and observation group （n = 48 for each group） according to operative methods. Observation group was treated with endoscopic fixation with metal stent, combined with elective surgery, while control group was treated with emergency op- eration. Coincidence rate of one stage resection, operative time, postoperative ventilation time, incidence rate of complications during hospitalization and mortality during hospitalization were compared between two groups. Results In observation group, coincidence rate of one stage resection was significantly higher, while operative time and postoperative ventilation time were significantly shorter than those in control group （ P 〈 0.05, P 〈 0.01 ）. There was no significant difference in length of stay between two groups （ P 〉 0.05 ）. Incidence rate of postoperative complications in observation group was significantly lower than that in control group （P 〈 0.05 ）. There were 1 death case in observation group and 2 death cases in control group. Conclusion Endoscopic stent implantation with elective surgery in application of patients with obstructive colorectal cancer may achieve better safe, increase coincidence rate of one stage resection and reduce incidence rate of complications, and therefore it can be used as an effective method in treatment of patients with obstructive colorectal cancer.