摘要
目的探讨肠道支架置入联合腹腔镜手术治疗梗阻性左半结肠癌的临床疗效。方法选取2016年1月至2022年6月于上海市普陀区利群医院普外科收治的28例左半结肠癌合并肠梗阻患者为研究对象,采用肠道支架置入联合腹腔镜手术进行治疗。观察并记录肠道支架置入情况、相关临床指标和腹腔镜手术情况。结果所有患者均成功置入肠道支架,无肠道支架移位、脱落或肠穿孔。所有患者2周后均行腹腔镜手术。腹腔镜手术前患者的白细胞计数、血红蛋白水平、白蛋白水平、血钾浓度均优于入院时(均P<0.05)。腹腔镜手术后无腹腔出血患者,2例出现切口感染,3例行预防性末端回肠造口术,并于造口术后3个月后行造口还纳术,其中1例出现吻合口漏。上述患者经保守治疗后均痊愈出院,无围手术期死亡病例。结论肠道支架置入联合腹腔镜手术治疗梗阻性左半结肠癌安全可靠,术前先行肠道支架置入可有效地缓解肠梗阻症状,为进一步的腹腔镜手术提供了良好的机会。
Objectives To investigate the clinical efficacy of intestinal stent placement combined with laparoscopic surgery in the treatment of obstructive left-sided colon cancer.Methods Twenty-eight patients with left-sided colon cancer complicated with intestinal obstruction,who were admitted to the Department of General Surgery at Liqun Hospital in Putuo District,Shanghai from January 2016 to June 2022,were selected as the study subjects.Intestinal stent placement combined with laparoscopic sur⁃gery was performed in all the patients.The intestinal stent placement and relevant clinical parameters,as well as laparoscopic surgery-related indicators,were observed and recorded.Results All patients successfully underwent intestinal stent placement without displacement,detachment,or intestinal perforation.All patients underwent laparoscopic surgery two weeks later.The white blood cell count,hemoglobin level,albumin level,and blood potassium concentration of the patients before laparoscopic surgery were superior to those at admission(P<0.05).No patients experienced intra-abdominal bleeding after laparoscopic surgery.Two patients had incision infection,while three required prophylactic terminal ileostomy.After three months,ileostomy closure was per⁃formed,with one patient experiencing anastomotic leakage.All affected patients recovered after conservative treatment,with no perioperative deaths recorded.Conclusion Intestinal stent placement combined with laparoscopic surgery offers a safe and reli⁃able treatment approach for obstructive left-sided colon cancer.Preoperative intestinal stent placement effectively relieves intesti⁃nal obstruction symptoms,and provides a good opportunity for further laparoscopic surgery.
作者
杨智岗
车鸣桦
黄海
何承祥
Yang Zhigang;Che Minghua;Huang Hai;He Chengxiang(Department of General Surgery,Liqun Hospital,Putuo District,Shanghai 200333,China)
出处
《结直肠肛门外科》
2023年第4期363-367,共5页
Journal of Colorectal & Anal Surgery
关键词
肠梗阻
左半结肠癌
肠道支架
腹腔镜手术
intestinal obstruction
left-sided colon cancer
intestinal stent
laparoscopic surgery
