外科手术联合可伸缩支架治疗梗阻性结肠癌的研究  

Analysis of surgery combined with retractable stent in treatment of obstructive colon cancer

作　　者：万天琪 王时俊[1] 杨海龙 尹少军 孙伟鹏 WAN Tian-qi;WANG Shi-jun;YANG Hai-long;YIN Shao-jun;SUN Wei-peng(Department of Colorectal and Anal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院结直肠肛门外科,郑州450052

出　　处：《医药论坛杂志》2025年第5期515-518,523,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200292)。

摘　　要：目的探讨外科手术联合可伸缩支架治疗梗阻性结肠癌的安全性和临床疗效。方法回顾性分析郑州大学第一附属医院2017年9月—2023年7月收治的72例梗阻性结肠癌的患者,按不同的治疗方法分为两组,其中术前在数字减影血管造影(digital subtraction angiography,DSA)引导下放置可伸缩支架并择期手术的患者作为研究组(34例),直接急诊手术的患者作为对照组(38例)。分析比较两组患者的基线资料、手术情况及相关指标、术后并发症情况、术后生存及复发转移情况。结果两组均顺利完成手术。研究组与对照组患者的基线资料比较,差异均无统计学意义(P均>0.05)。其中研究组在腹腔镜手术率[91.2%(31/34)vs 42.1%(16/38),P=0.03]、术中临时性造口[12.9%(4/34)vs 44.7%(17/38),P<0.05]、手术时间[(168.55±46.68)min vs(203.47±53.21)min,P<0.05]、术中出血量[(69.74±40.86)mL vs(150.33±77.65)mL,P<0.05]、术后出院时间[(9.53±1.56)vs(12.78±1.81),P<0.05]、术后并发症发生率[8.8%(3/34)vs 21.1%(8/38),P<0.05]上均优于对照组。两组患者在术后3年病死率和局部复发或远处转移率上差异均无统计学意义(P均>0.05)。结论外科手术联合可伸缩支架治疗梗阻性结肠癌是一种安全可行、更加微创、术后并发症少的方法。Objective To investigate the safety and clinical efficacy of surgery combined with retractable stents in the treat-ment of obstructive colon cancer.Methods A retrospective analysis was performed for 72 patients with obstructive colon canc er admitted to the First Affiliated Hospital of Zhengzhou University from September 2017 to July 2023,and they were divided into two groups according to different treatments.Patients who were placed with retractable stent under the guidance of DSA before surgery were selected as the research group(34 cases),and patients undergoing direct emergency surgery were served as the control group(38 cases).The baseline data,surgery and related indicators,postoperative complications,postoperative survival and recurrence or metastasis of the two groups were analyzed and compared.Results The operation was successfully completed in both groups.There was no significant difference in baseline data between the research group and the control group(all P>0.05).The research group was superior to the control group in laparoscopic surgery rate[91.2%(31/34)vs 42.1%(16/38),P=0.03],intraoperative temporary ostomy[12.9%(4/34)vs 44.7%(17/38),P<0.05],operation time[(168.55±46.68)vs(203.47±53.21),P<0.05],intraoperative blood loss[(69.74±40.86)vs(150.33±77.65),P<0.05],postoperative hospitalization time[(9.53±1.56)vs(12.78±1.81),P<0.05]and postoperative complication rate[8.8%(3/34)vs 21.1%(8/38),P<0.05].There was no significant difference in postoperative mortality rate and local re-currence or distant metastasis rate between the two groups at 3 years after surgery(all P>0.05).Conclusion Surgery com-bined with retractable stent for the treatment of obstructive colon cancer is a safe,feasible,less invasive and less postoperative complications.

关 键 词：外科手术 可伸缩支架 结肠肿瘤 肠梗阻 

分 类 号：R735.35[医药卫生—肿瘤]