摘要
目的评价自膨式金属支架在晚期结直肠癌所致完全性肠梗阻中的安全性以及有效性。方法我院2016~2018年间收治晚期结直肠癌所致完全性肠梗阻病人55例,支架组37例,采用自膨式金属支架治疗;手术组18例,采用肠造口术治疗;比较两组病人术后的技术成功率、临床成功率、住院时间、早期和晚期不良事件和总生存率。结果支架组获得技术成功35例,技术成功率为94.6%(35/37),手术组技术成功18例,技术成功率为100%(18/18)。89.2%的结肠支架置入术病人和100%的手术病人获得了临床缓解(P>0.05)。支架组和手术组早期不良事件发生率分别为10.8%和27.8%,住院期间死亡率分别为0和5.56%,差异无统计学意义(P>0.05)。支架组平均手术时间为38.6分钟,手术组为123.9分钟,支架组平均住院时间为5天,手术组为16天,两组比较差异有统计学意义(P<0.05)。两组晚期不良事件发生率分别为13.5%和11.1%,差异无统计学意义(P>0.05)。150周时,支架组病人生存率为29.7%,手术组为44.4%,差异无统计学意义(P>0.05)。结论自膨式肠道支架在晚期结直肠癌所致完全性肠梗阻治疗中应用效果良好,可缩短病人住院时间,不增加术后并发症,提高病人术后生活质量,病人远期生存与肠造口相当。
Objective To evaluation the safety and efficacy of self expanding metallic stent in the treatment of complete intestinal obstruction caused by advanced colorectal cancer.Methods The clinical data of 55 patients with complete intestinal obstruction caused by advanced colorectal cancer from 2016 to 2018 in Wuhan Union Hospital Affiliated to Tongji Medical College of Huazhong University of Sci-ence and Technology were analyzed retrospectively.Patients were treated with self-expanding metal stents(stent group,n=37)and surgery(surgery group,n=18).The postoperative technical success rate,clini-cal success rate,length of stay,early and late adverse events and overall survival rate were statistically an-alyzed in both groups.Results35 patients in the stent group achieved technical success with a technical success rate of 94.6%(35/37),while 18 patients in the surgical group achieved technical success with a technical success rate of 100%(18/18).Clinical remission was achieved in 89.2%of patients with colon stenting and 100%of surgical patients(P>0.05).Compared with the surgical group,the incidence of ear-ly adverse events was significantly lower in the stent group(10.8%vs 27.8%,P>0.05).The mortality rate was 0 in the stent group during the hospital,compared with 5.56%in the surgical group(P>0.05).The average operation time(38.6 min)in stent group was significantly shorter than that in operation group(123.9 min)(P<0.05).Compared with the surgery group(16 days),the average length of hospital stay(5 days)was significantly shorter(P<0.05).The incidence of late postoperative adverse events was com-parable between the two groups(13.5%vs 11.1%,P>0.05).At 150 weeks,the survival rate was 29.7%in the stent group and 44.4%in the surgical group(P>0.05).Conclusion Self-expanding in-testinal stent is effective in the treatment of complete intestinal obstruction caused by advanced colorectal cancer,which can significantly shorten the hospitalization time of patients,not increase postoperative com-plications,and greatly improve the quali
作者
曹英豪
吴轲
古俊楠
刘兴华
赵刚
刘红利
杨佳
曹恒
邓胜和
王继亮
陶凯雄
王国斌
刘莉
缪小平
李疆
蔡开琳
CAO Yinghao;WU Ke;GU Junnan(Department of Gastrointestinal Surgery,Union Hospital,Tongji Medi-cal College,Huazhong University of Science and Technology,Wuhan 430022,China)
出处
《临床外科杂志》
2020年第5期429-432,共4页
Journal of Clinical Surgery
基金
华中科技大学同济医学院临床研究型临床医师资助计划项目(5001530016)
国家重点基础研究发展资助计划项目(2015CB554007)
吴阶平基金资助项目(320.2710.1843)
湖北省自然基金资助项目(2018CFC884)。
关键词
结直肠癌
完全性肠梗阻
自膨式金属支架
肠造口术
colorectal cancer
complete intestinal obstruction
self expanding metal stent
enterostomy
