Abstract:

Objective

To observe the clinical application effect of three surgical methods （stent placement+laparoscopic surgery，laparotomy+intraoperative enteric cavity irrigation，stent placement+laparotomy） on patients with colorectal cancer （CRC） complicated with intestinal obstruction （IO），and to analyze the influence on gastrointestinal function indicators and inflammatory indicators of patients.

Methods

The clinical data of 108 patients with CRC complicated with IO in the hospital were retrospectively analyzed from June 2021 to June 2024，and the patients were divided into group A （stent placement+laparoscopic surgery，n=39 cases），group B （laparotomy+intraoperative stent placement，n=34 cases） and group C （stent placement+laparotomy，n=35 cases） according to different surgical methods.SPSS 22.0 software was used for data analysis.Measurement data such as surgical indicators and inflammatory indicators were analyzed by One-WayANOVA of variance.Enumeration data such as complications were analyzed by χ² test.P＜0.05 was considered statistically significant.

Results

There was no significant difference in the operation time among the three groups （P＞0.05）.There were significant differences in the intraoperative blood loss，postoperative exhaust time，time to first get out of bed after surgery，and length of hospital stay among the three groups（P＜0.05）.The intraoperative blood loss in Groups B and C was higher than that in Group A （P＜0.05），and the postoperative exhaust time，time to first get out of bed after surgery，and length of hospital stay in Groups B and C were longer than those in Group A （P＜0.05）.The levels of carbohydrate antigen 125 （CA125） and vascular endothelial growth factor （VEGF） in the three groups decreased significantly 4 weeks after surgery （P＜0.05），but there was no significant difference among the three groups （P＞0.05）.There were significant differences in the levels of lymphocyte - to - monocyte ratio （LMR），motilin，vasoactive intestinal peptide （VIP），tumor necrosis factor - α （TNF - α），and interleukin - 6 （IL- 6） among the three groups after surgery （P＜0.05）.The LMR，motilin，and VIP levels in Groups B and C were lower than those in Group A （P＜0.05），while the levels of TNF - α and IL - 6 were higher than those in Group A （P＜0.05）.There was a significant difference in the total incidence of postoperative complications among the three groups （P＜0.05），and the incidence in Group A was significantly lower than that in Group B （P＜0.05）.

Conclusion

For patients with colorectal cancer complicated by intestinal obstruction，treatment with stent placement + laparoscopic surgery can reduce the patients’ inflammatory response and the impact on gastrointestinal function，thus contributing to postoperative recovery.

Key words: Colorectal Neoplasms, Intestinal Obstruction, Laparotomy, Laparoscopes, Stent Implantation, Gastrointestinal Function, Inflammation