内镜支架置入术对左侧大肠癌性梗阻腹腔镜手术效果及安全性影响

Effect of endoscopic stent implantation on laparoscopic surgery and safety of left colorectal cancer obstruction

目的探讨内镜支架置入术对左侧大肠癌性梗阻腹腔镜手术效果及安全性影响。方法研究对象选取我院2015年2月到2016年2月间收治的左侧大肠癌性梗阻患者46例,采用随机数字法将其分为对照组(23例)和观察组(23例)。对照组行腹腔镜根治性切除吻合术,行术中结肠灌洗;观察组采用内镜支架置入术缓解肠梗阻后,择期再行腹腔镜根治性切除吻合术,比较两组患者的手术效果及并发症发生率。结果观察组肿瘤根治性切除率(91.30%)明显高于对照组(65.22%)(χ~2=4.60,P=0.03);观察组清扫淋巴结数明显高于对照组(P<0.05),切口长度明显短于对照组(P<0.05),术中出血量、手术时间、住院天数、住院费用明显少于对照组(P<0.05);观察组并发症发生率(4.35%)明显低于对照组(26.09%)(χ~2=4.21,P=0.04)。结论内镜支架置入术可提高左侧大肠癌性梗阻腹腔镜手术的肿瘤根治性切除率,促进患者术后恢复,且安全性高,值得临床推广。

Objective:To explore the effect of endoscopic stent implantation on laparoscopic surgery and safety of left colorectal cancer obstruction.Methods:Forty-six patients with the left colorectal cancer obstruction were selected from our hospital between February2015and February2016,and were divided into control group(n=23)and treatment group(n=23)by random number method.The patients in the control group underwent laparoscopic radical resection and anastomosis.The patients underwent laparoscopic radical resection and anastomosis.The patients in the two groups were treated with endoscopic stenting.Surgical effects and complications.Results:The tumor resection rate(91.30%)was significantly higher in the observation group than that in the control group(65.22%)(χ2=4.60,P=0.03).The number of lymph nodes in the observation group was significantly higher than that in the control group(P<0.05).The incision length was significantly shorter than that of the control group(P<0.05).The intraoperative blood loss,operation time,hospital stay and hospitalization cost were significantly less than those in the control group(P<0.05).The incidence of complications in the observation group(4.35%)was significantly lower than that in the control group(26.09%)(χ2=4.21,P=0.04).Conclusion:Endoscopic stent placement can improve the radical resection rate in the left colorectal cancer obstruction laparoscopic surgery,and promote patients'postoperative recovery,and it is safe,which is worthy of clinical promotion.