Yun Jong Hyouk, Jung Gyoo-Sik
J Korean Soc Radiol. 2023 May;84(3):615-626. doi: 10.3348/jksr.2022.0097. Epub 2023 Apr 21.
To assess the outcomes of single-stage surgery following fluoroscopic stent placement for malignant colorectal obstruction.
This retrospective study included 46 patients (28 male and 18 female; mean age, 67.2 years) who had undergone fluoroscopic stent placement followed by laparoscopic resection ( = 31) or open surgery ( = 15) for malignant colorectal obstruction. The surgical outcomes were analyzed and compared. After a mean follow-up of 38.9 months, the recurrence-free and overall survival were estimated, and prognostic factors were evaluated.
The mean interval between stent placement and surgery was 10.2 days. Primary anastomosis was possible in all patients. The mean postoperative length of hospitalization was 11.0 days. Bowel perforation was detected in six patients (13.0%). During the follow-up, ten patients (21.7%) developed recurrence; these included five of the six patients with bowel perforation. Bowel perforation had a significant effect on recurrence-free survival ( = 0.010).
Single-stage surgery following fluoroscopic stent placement may be effective for treating malignant colorectal obstruction. Stent-related bowel perforation is a significant predictive factor for tumor recurrence.
评估荧光透视下支架置入术后行一期手术治疗恶性大肠梗阻的疗效。
本回顾性研究纳入46例患者（男性28例，女性18例；平均年龄67.2岁），这些患者因恶性大肠梗阻先行荧光透视下支架置入术，随后接受腹腔镜切除术（n = 31）或开放手术（n = 15）。分析并比较手术疗效。平均随访38.9个月后，评估无复发生存率和总生存率，并分析预后因素。
支架置入与手术之间的平均间隔时间为10.2天。所有患者均可行一期吻合。术后平均住院时间为11.0天。6例患者（13.0%）发生肠穿孔。随访期间，10例患者（21.7%）出现复发；其中包括6例肠穿孔患者中的5例。肠穿孔对无复发生存率有显著影响（P = 0.010）。
荧光透视下支架置入术后行一期手术治疗恶性大肠梗阻可能有效。与支架相关的肠穿孔是肿瘤复发的重要预测因素。
