Objective
To explore the clinical efficacy and safety of colorectal stents combined with laparoscopic radical surgery for left colon cancer with intestinal obstruction.
Methods
A retrospective analysis of ninety patients with radical resection of left colon cancer with intestinal obstruction from January 2012 to December 2016 in Jiangmen Central Hospital was carried out. Patients were divided into two groups according to the treatment method: combined treatment group (33 cases, received early enteric stent implantational sequence with first-stage laparocopic resection and anastomosis) and simple operation group (57 cases, underwent emergency operation). Clinical success rates, safety, and surgical outcomes were compared between two groups.
Results
In the combined treatment group, 3 cases failed to place the stent through the stenosis. No patient had stent implantation related perforation, stent displacement, bleeding or postoperative intestinal perforation. The technical success rate and clinical success rate were both 90.9% (30/33). Laparoscopic radical resection was performed in 30 cases 3-5 d after stenting without prophylactic intestinal stoma. The average operation time of the combined treatment group and the simple operation group was (274.6±58.4) min and (294.3±54.2) min, with no statistically significant difference (t=1.569, P=0.120). The amount of bleeding in the combined treatment group was significantly lower than that of the simple operation group [(35.4±20.4) ml vs (135.5±26.9) ml, t=17.84, P<0.001]. No patient died during the perioperative period. There were no significant differences in overall complications, infectious complications, and non-infectious complications between the two groups.
Conclusion
As a pre-operative bridge for laparoscopic radical surgery, the application of colorectal stents in left colon cancer with intestinal obstruction is safe and effective, with acceptable complication rate, similar clinical short-term outcome, and preventive enterostomy is avoided.
Key words:
Colonic neoplasms; Intestinal obstruction; Stents; Laparoscopes
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