支架置入术治疗结直肠癌并发肠梗阻临床分析

目的探讨内镜引导下金属内支架置入术治疗结直肠癌并发肠梗阻的临床效果。方法回顾性分析2008年1月至2010年12月恩施州中心医院收治的20例结直肠癌并发肠梗阻患者的临床资料,在内镜引导下先行金属支架置入术,待梗阻症状和全身情况改善后,再行肠管Ⅰ期切除吻合术。结果 20例患者金属支架置入一次成功19例,1² d后梗阻症状均消除或缓解,72 d后梗阻症状均消除或缓解,7¹0 d后18例行肠管Ⅰ期切除吻合术,术后恢复顺利,无感染及吻合口漏等并发症;随访9010 d后18例行肠管Ⅰ期切除吻合术,术后恢复顺利,无感染及吻合口漏等并发症;随访90¹80 d,1例于术后51 d肠梗阻症状复发,再行外科手术死于心力衰竭;1例因癌细胞转移,术后83 d死于全身衰竭。结论经内镜引导下置入金属内支架治疗结直肠癌并发肠梗阻成功率高,安全、经济,短期效果明显。

Clinical Analysis on the Stenting Treatment for Colorectal Cancer with Intestinal Obstruction

Objective To explore the clinical effect of endoscopic metal stenting treatment for colorectal cancer with intestinal obstruction.Methods Clinical data of 20 cases of patients with colorectal cancer accompanied with intestinal obstruction admitted in Enshi Central Hospital from Jan.2008 to Dec.2010 were retrospectively analyzed.The patients were firstly treated with metal stenting under endoscopic guidance,after the obstructive symptoms and general condition improved,patients were given intestine resection and anastomosis of phase Ⅰ.Results The metal stenting treatment was successful in 19 cases out of 20,and the obstructive symptoms were eliminated or alleviated 1-2 d after treatment.Intestine resection and anastomosis of phase Ⅰ were given to 18 cases 7-10 d after stenting,and the postoperative recovery was smooth,with no infection and complications of anastomotic mouth leakage and others.During 90-180 d of follow-up,only 1 case had recurrence of symptoms 51 d after operation,and then died of heart failure under surgical operation;and 1 case died of systemic failure 83 d after operation due to metastasis.Conclusion Endoscopic-guided metal stenting treatment for colorectal cancer with intestinal obstruction is safe and economical with high success rate and obvious shortterm effect.