Abstract:

Objective

To explore the curative effect of different operation methods in the treatment of obstructive left colorectal cancer.

Methods

Clinical data of 103 patients with obstructive left half colorectal cancer from January 2019 to January 2021 were retrospectively analyzed.According to the operative plan， they were divided into the elective group （receiving intestinal stent combined elective surgery， n=54 cases） and the conventional group （receiving routine emergency stage I tumor resection and anastomosis， n=49 cases）.Data were analyzed using SPSS22.0 statistical software.The incidence of postoperative complications， stage I anastomosis rate， stomy rate and laparotomy rate were expressed as［ cases （%）］， χ² test was performed.Perioperative indexes and intestinal barrier function （DAO， D-lactic acid） 3 months after surgery were expressed in the form of （x± s ）， and independent sample t test was performed.Kaplan-Meier was used to draw the survival curve for the 3-year survival.P＜0.05 was statistically significant.

Results

The operative time， intraoperative blood loss， number of lymph node dissection， permanent stomy rate and laparotomy rate of the elective group were significantly lower than those of the conventional group （P＜0.05）， and the anastomosis rate of stageⅠwas significantly higher than that of the conventional group （P＜0.05）.The complication rate of the selective group（13.0%） was significantly lower than that of the conventional group （30.6%） （P＜0.05）.Three months after surgery， DAO and D-lactic acid were significantly increased in 2 groups （P＜0.05）， and the selective group was significantly lower than the conventional group （P＜0.05）.All patients were successfully followed up for 3 years with a median follow-up time of 27 months.The progression-free survival （PFS） and overall survival （OS） in the selective group were （31.6±8.3） months and （33.9±5.3） months respectively.PFS and OS in the conventional group were （33.0±6.6） months and （34.8±3.4） months， and there was no statistical significance in OS and PFS in the two groups （P＞0.05）.

Conclusion

Intestinal stents combined with elective surgery have significant advantages in shortening operation time， reducing intraoperative blood loss， reducing the rate of permanent ostomy and laparotomy， and improving the rate of stage I anastomosis.Besides， the prognosis of patients is good with few complications， and it is worthy of application.

Key words: Colorectal Neoplasms,Obstructive, Intestinal Stent, One-Stage Resection and Anastomosis, Complications