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疗效

Clinical efficacy of laparoscopic surgery after anal intestinal obstruction catheter decompression and intestinal stenting decompression in the treatment of obstructive colorectal cancer

目的探讨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疗效。方法选取2019年5月至2021年4月常州市金坛区中医医院收治的80例梗阻性结直肠癌患者作为研究对象,根据手术方式不同分为导管减压组与支架减压组,各40例。两组均行腹腔镜手术,导管减压组行经肛门肠梗阻导管减压,支架减压组行经肠道支架植入术减压,比较两组围术期相关体征指标、开腹率和并发症发生率。结果支架减压组术前胃肠减压时间、术后腹痛缓解时间、术后腹胀缓解时间、气液平面消失时间均短于导管减压组,差异有统计学意义(P<0.05)。支架减压组开腹率和并发症发生率均低于导管减压组,差异有统计学意义(P<0.05)。结论经肠道支架植入术减压治疗梗阻性结直肠癌疗效优于经肛门肠梗阻导管减压法,可缩短症状消失时间,降低并发症发生率及开腹率,值得临床推广应用。

Objective To investigate the clinical efficacy of laparoscopic surgery after anal intestinal obstruction catheter decompression and in-testinal stenting decompression in the treatment of obstructive colorectal cancer.Methods 80 patients with obstructive colorectal cancer admitted to Changzhou Jintan District Hospital of Traditional Chinese medicine,from May 2019 to April 2021 were selected as the research subjects,and they were divided into catheter decompression group and stent decompression group according to different surgical methods,with 40 cases in each group.Both groups underwent laparoscopic surgery,the catheter decompression group underwent anal intestinal obstruction catheter decompression,and the stent decompression group underwent intestinal stenting decompression,the perioperative signs,laparotomy rate and complication rate of the two groups were compared.Results The preoperative gastrointestinal decompression time,postoperative abdominal pain relief time,postoperative ab-dominal distension relief time and the disappearance time of gas-liquid level in the stent decompression group were shorter than those in the catheter decompression group,and the differences were statistically significant(P<0.05).The laparotomy rate and complication rate of stent decompression group were lower than those of catheter decompression group,and the differences were statistically significant(P<0.05).Conclusion The effect of intestinal stenting decompression in the treatment of obstructive colorectal cancer is better than that of anal intestinal obstruction catheter decompres-sion,which can shorten the time of symptom disappearance,reduce the incidence of complications and the rate of laparotomy,which is worthy of clinical promotion and pplication.