Endoscopic Stent Implantation Combined With Laparoscopic One-stage Anastomosis And Hartmann Operation Clinical Comparative Study On The Treatment Of Obstruction Of Left Colon Cancer

Objective:The clinical efficacy and short-term effects of endoscopic stent implantation combined with laparoscopy and Hartmann in the treatment of left hemicolon carcinoma obstruction were analyzed retrospectively,providing Suggestions and methods for clinical work of gastrointestinal surgery.Methods:Fifty-three patients with left colon cancer obstruction admitted to department of general surgery,first hospital of shanxi medical university from January 2015 to November 2018 were collected,including 28 patients in the stent implantation combined with laparoscopy group(double-lens group)and 25 patients in the Hartmann operation group.Time of first postoperative exhaust,time of first postoperative fluid intake,time of first postoperative activity,time of hospitalization;Postoperative complications;The number of lymph nodes,positive rate of peripheral resection margin and survival rate,mortality rate and disease-free survival rate of patients in the two groups were different.Results:1.Age,gender,BMI and tumor stage of patients in the two groups were statistically analyzed by P>0.05,with no statistical significance.2.Intraoperative blood loss of the patients in the double-lens group was less than that in the Hartmann group(P<0.001);Incision length: the double-lens group was shorter than the Hartmann group(P<0.001).There was no significant difference inoperation time between the two groups(P>0.05).3.The time of postoperative first exhaust,intake of fluid,time of underground activity and time of hospitalization were all shorter in the double-lens group than in the Hartmann group(P<0.05).In addition,there was no significant difference in the number of lymph nodes between the two groups(P>0.05).The positive rate of circumferential circumferential margin was 0% in the two groups.There was no significant difference in postoperative complications(P>0.05).After 1 year follow-up,the survival rate,mortality and disease-free survival rate of the double-lens group were 96%,4% and 95.8%,respectively.The Hartmann group had 95.7% survival,4.3% mortality and 95.4% disease-free survival.Conclusion:Endoscopic stent implantation combined with laparoscopic radical resection of left colon cancer is safe and feasible,which can reduce intraoperative blood loss,achieve rapid postoperative rehabilitation,improve postoperative comfort of patients,shorten postoperative hospitalization time,and achieve rapid physiological and psychological rehabilitation of patients.