肠道支架置入联合腹腔镜手术治疗左半结肠癌梗阻的疗效分析

目的:比较加速康复外科理念指导下的肠道支架置入后联合腹腔镜手术与急诊开腹手术治疗左半结肠癌性梗阻患者的短期疗效，探讨加速康复外科理念指导下肠道支架置入后腹腔镜手术在左半结肠癌梗阻治疗中的应用效果。方法:回顾性分析 2016年01月至2019 年 10 月在我院普外一科治疗的56例左半结肠癌并完全性肠梗阻患者。根据治疗方式将患者分为对照组（急诊开放手术组）30例，支架组（加速康复外科理念指导下肠道支架置入联合腹腔镜手术组）26例。收集患者临床资料，对支架置入并发症、一期吻合切除率、肠造口率、手术相关指标、住院时间等进行分析。 结果:两组患者在性别、年龄及肿瘤大小方面差异无统计学意义(P＞0.05)。支架组与对照组在手术时长、出血量、术后进食时间、住院时间、淋巴结数目、造口率、切口感染率、一期吻合率差异具有统计学意义（P＜0.05），其中对照组的手术时长、出血量、术后进食时间、造口率、切口感染率高于支架组，支架组的住院时间、淋巴结数目高于对照组。结论:加速康复外科指导下的肠道支架置入联合腹腔镜手术疗效及安全性确切，可以提高一期吻合率，减少造口率。

Efficacy analysis of intestinal stent implantation combined with laparoscopic surgery for left colon cancer obstruction

Objective:To compare the short-term efficacy of sequential laparoscopic surgery after intestinal stent placement and emergency surgery in the treatment of left colon cancer obstruction,and to explore the efficacy and safety of intestinal stent placement combined with laparoscopic surgery in the treatment of left colon cancer obstruction.Methods:A retrospective analysis was performed on 56 cases of left hemicolon carcinoma with complete ileus treated in the first department of general surgeryi our hospital from January 2016 to October 2019.The patients were divided into a control group(emergency open surgery group)and a stent group(under the guidance of ERAS,intestinal stent implantation combined with laparoscopic surgery group)according to the treatment mode.The clinical data of the patients were collected and analyzed for the complications of stent implantation,first-stage anastomosis rate,enterostomy rate,surgical related indicators,hospital stay and so on.Results:There were no statistically significant differences in gender,age or tumor length between the two groups(P>0.05).Stent group and control group in the operation time,blood loss,postoperative eating time,length of hospital stay,number of lymph nodes,colostomy rate,incision infection rate,a self-agreement differences statistically significant(P<0.05),in which the control of the operation time,blood loss,postoperative time of food intake,rate of colostomy,incision infection rate higher than the stent group,stent group length of hospital stay,number of lymph nodes was higher than the control group.Conclusion:The clinical effect and safety of intestinal stent implantation combined with laparoscopic surgery under the guidance of ERAS can improve the primary anastomosis rate and reduce the stoma rate.