肠道支架置入联合腹腔镜手术应用于梗阻性左半结肠癌治疗的临床价值分析

Clinical Value Analysis of Intestinal Stent Implantation Combined with Laparoscopic Surgery in the Treatment of Obstructive Left Colon Cancer

目的分析肠道支架置入联合腹腔镜手术应用于梗阻性左半结肠癌治疗的临床价值。方法随机选取2018年8月—2023年4月上海杨思医院100例梗阻性左半结肠癌患者为研究对象,采用随机对照试验设计,在计算机随机数字生成下将患者分为两组,观察组(n=50)为肠道支架置入联合腹腔镜手术治疗,对照组(n=50)为传统治疗。比较两组患者手术时间、出血量、术后进食时间、住院时间、切口感染率、腹腔感染率、血清肿瘤标志物水平以及Ⅰ期手术吻合成功率。结果两组患者手术时间[(183.19±22.31)min vs(182.46±32.74)min]比较,差异无统计学意义(P>0.05)。观察组术中出血量(67.75±23.13)mL低于对照组的(211.36±11.81)mL,差异有统计学意义(t=39.101,P<0.05)。观察组术后住院时间及术后进食时间均短于对照组,差异有统计学意义(P均<0.05)。术后,观察组甲胎蛋白、癌胚抗原均低于对照组,差异有统计学意义(P均<0.05)。观察组一期手术吻合成功率高于对照组,感染总发生率均低于对照组,差异有统计学意义(P均<0.05)。结论梗阻性左半结肠癌患者采用肠道支架置入联合腹腔镜手术治疗效果较为理想,术后恢复较快,且感染发生率较低,可有效提高一期吻合术的成功率。

Objective To analyze the value of intestinal stent implantation combined with laparoscopic surgery in the treatment of obstructive left colon cancer.Methods A total of 100 patients with obstructive left colon cancer in Shanghai Yangsi Hospital from August 2018 to April 2023 were randomly selected as the study objects.A randomized controlled trial design was adopted,and the patients were divided into two groups by computer random number generation.The observation group(n=50)received intestinal stent implantation combined with laparoscopic surgery,and the control group(n=50)received traditional treatment.The operation time,blood loss,postoperative feeding time,hospital stay,incisional infection rate,abdominal infection rate,serum tumor marker level and the success rate of stage I anastomosis were compared between the two groups.Results There was no significant difference in operation time between the two groups[(183.19±22.31)min vs(182.46±32.74)min](P>0.05).The intraoperative blood loss in the observation group was(67.75±23.13)mL,which was lower than(211.36±11.81)mL in the control group,and the difference was statistically significant(t=39.101,P<0.05).The postoperative hospitalization time and postoperative feeding time of the observation group were shorter than those of the control group,and the differences were statistically significant(both P<0.05).After operation,alpha-fetoprotein and carcinoembryonic antigen in observation group were lower than those in control group,and the differences were statistically significant(both P<0.05).The successful rate of anastomosis in the observation group was higher than that in the control group,and the total incidence of infection was lower than that in the control group,the differences were statistically significant(both P<0.05).Conclusion Intestinal stent implantation combined with laparoscopic surgery is ideal for patients with obstructive left colon cancer,and the postoperative recovery is faster and the incidence of infection is lower,which can effectively improve the success rate of one-stage anastomosis.