经肛门肠梗阻导管减压与经肠道支架植入术减压后腹腔镜手术治疗梗阻性结直肠癌的对比观察

Transanal ileus tube decompression and intestinal stent implantation decompression laparoscopic surgery comparative observation on treatment of obstructive colorectal cancer

目的对比观察经肛门肠梗阻导管减压与经肠道支架植入术减压后腹腔镜手术治疗梗阻性结直肠癌的临床效果。方法采用前瞻性研究法,将63例梗阻性结直肠癌患者随机分为两组,A组(n=31)于肛肠梗阻导管置入术后行腹腔镜下结直肠癌根治、肠管Ⅰ期吻合术;B组(n=32)于肠道支架置入术后行腹腔镜下结直肠癌根治、肠管Ⅰ期吻合术。比较两组患者的手术情况与术后情况。结果两组患者的肠道准备时间、中转开腹情况、造瘘情况、手术时间、术中出血量、左髂切口长度方面的差异均无统计学意义(P>0.05);两组患者术后切口感染、吻合口漏、肛门排气时间、进流食时间、住院时间的差异均无统计学意义(P>0.05);术后随访6个月,两组均未发现切口及Trocar穿刺口肿瘤种植。结论经肛门肠梗阻导管减压与经肠道支架植入术减压后行腹腔镜手术治疗梗阻性结直肠癌均疗效确切,操作安全,均具有较高的可行性。

Objective To compare the clinical effects of transanal ileus catheter decompression and intestinal stent implantation decompression [revision of the word ＇Blue＇ in English],laparoscopic surgery for obstructive colorectal cancer. Methods Using prospective study,63 cases of obstructive colorectal cancer patients were randomly divided into two groups,group A（ n = 31） in anus bowel obstruction catheter surgery after laparoscopic colorectal cancer effect A radical cure,insufflate Ⅰ stage anastomosis,group B（ n = 32） in the intestinal carotid stenting after laparoscopic colorectal cancer effect A radical cure,insufflate Ⅰ stage anastomosis. The situation of surgery in two groups of patients with postoperative situation were compared. Results The differences of intestinal preparation time,transit operation situation and situation of colostomy,operation time,intraoperative blood loss,left iliac incision length in the two groups had no statistical significance（ P〈0. 05）. There was no statistically significant difference in postoperative incision infection,anastomotic leakage,anal vent time,feeding time,and hospitalization time（ P〈0. 05）. After 6 months of follow-up,no incisions and trocar piercings was found in both groups. Conclusion The efficacy and safety of laparoscopic surgery for the treatment of obstructive colorectal cancer after the decompression of the anal obstruction and the decompression of the intestinal stent are more feasible.