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内镜支架置入联合腹腔镜治疗左半结肠癌伴梗阻的疗效

The efficacy of endoscopic stenting combined with laparoscopy in the treatment of left colon cancer with obstruction.

作者信息

Li Wenming, Jin Xin, Liang Guogang

机构信息

Department of Acute Abdominal Surgery, First Affiliated Hospital Dalian Medical University, Dalian, Liaoning, China.

出版信息

J Cancer Res Ther. 2019;15(2):375-379. doi: 10.4103/jcrt.JCRT_111_18.

Abstract

CONTEXT

Endoscopic self-expandable metal stents (SEMSs) are the bridge of obstructive colorectal cancer surgery. The debate is still open on whether the procedure and effects can be the same between the SEMS combined obstructive colon cancer resection and nonobstructive colon cancer resection, both of which were under laparoscopic.

AIMS

This retrospective study was designed to compare whether the same effects could be achieved in both resections.

SETTINGS AND DESIGN

The retrospective analysis was from September 2016 to November 2017. In the observation group (OG), 20 patients hospitalized for obstruction of the left colon cancer were included, who received obstructive colon cancer laparoscopic resection (LR) combined with SEMS insertion. In control group (CG), 20 patients were randomly selected, who underwent nonobstructive colon cancer LR during this period.

SUBJECTS AND METHODS

The differences between the two groups were compared, including operation time, intraoperative blood loss, the number of removed lymph nodes, postoperative anal exhaust time, and hospital stay.

RESULTS

Both groups were comparable in the age, gender, weight, the distribution of tumor, lymph node metastasis, tumor, node, and metastasis staging, operation time, intraoperative blood loss, the number of removed lymph nodes, and postoperative anal exhaust time. The hospital stay was 15.2 ± 1.3 days and 14.2 ± 1.5 days in OG and CG, respectively, and it was longer in OG than that of in CG (P = 0.032).

CONCLUSIONS

Obstructive colon cancer LR combined with SEMS insertion was a safe and feasible radical treatment strategy. The same level of procedure and effects could be achieved, compared to that of nonobstructive colon cancer LR.

摘要

背景

内镜下自膨式金属支架(SEMSs)是梗阻性结直肠癌手术的桥梁。对于腹腔镜下SEMS联合梗阻性结肠癌切除术和非梗阻性结肠癌切除术的手术过程及效果是否相同,目前仍存在争议。

目的

本回顾性研究旨在比较两种切除术是否能取得相同效果。

设置与设计

回顾性分析时间为2016年9月至2017年11月。观察组(OG)纳入20例因左结肠癌梗阻住院的患者,他们接受了梗阻性结肠癌腹腔镜切除术(LR)并置入SEMS。对照组(CG)随机选取20例在此期间接受非梗阻性结肠癌LR的患者。

研究对象与方法

比较两组之间的差异,包括手术时间、术中出血量、切除淋巴结数量、术后肛门排气时间和住院时间。

结果

两组在年龄、性别、体重、肿瘤分布、淋巴结转移、肿瘤、淋巴结和转移分期、手术时间、术中出血量、切除淋巴结数量和术后肛门排气时间方面具有可比性。OG组和CG组的住院时间分别为15.2±1.3天和14.2±1.5天,OG组比CG组长(P=0.032)。

结论

梗阻性结肠癌LR联合SEMS置入是一种安全可行的根治性治疗策略。与非梗阻性结肠癌LR相比,可达到相同的手术水平和效果。

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