Analysis Of Endoscopy Assisted X-ray Stent Placement Clinical Effection Of Acute Malignant Colorectal Obstruction

Objective The clinical data of colonic metal stent implacement with acute malignant colonic obstruction were restrospectively analyzed.To summarize the clinical value of colonic metal stent insertion.To investigate the clinical effection of selective surgery after colonic metal stenting versus emergency surgery.Methods From January 2017 to December 2020,60 patients with acute malignant colonic obstruction were selected by using electronic case system in the First Affiliated Hospital of Bengbu Medical College.To summarize the clinical features of colon metal stent.A total of 50 patients(emergency surgery group),who underwent surgical operation for colorectal obstruction during the same period were the control group.The primary anastomosis rates,stoma rates and post-operative complications were compared between the two groups.Results Fifty-seven patients successfully implanted colon metal stent,with the technical success rate of 95.0%(57/60).The clinical remission rate was98.25%(56/57).The total rate of stent-associated complications was 7.14%.two cases of stent reobstruction(3.57%),one of stent migration(1.78%)and one bleeding(1.78%).After MDT evaluation,16 patients were treated with palliative chemotherapy.10 patients were treated with conservative treatment.30 patients underwent surgery within a median interval of 10 days(range,1-24 days)after endoscopic stent implantation.Open surgery was performed in 63.33% of cases and laparoscopic surgery in 30.0%,and two patients underwent Hartmann procedure.No significant differences were found in post-operative mortality rates(P=0.288),length of post-operative hospital stay(P=0.963),number of resected lymph nodes(P=0.764),overall post-operative complications rates(P=0.148)included pulmonary infection,wound infection,anastomotic leakage and inflammatory ileus(all P>0.05)between the two groups.The emergency surgery group resulted in higher stoma rates(96.0% vs6.67%,P<0.05),and the primary anastomosis rates of the stent group was significantly increased(93.33% vs 4.0%,P<0.05),amount of bleeding during operation was significantly decreased(39.0 vs 6.67 ml,P<0.05),Laparoscopic rates improved.Conclusion Endoscopy assisted X-ray stent placement can effectively relieve acute malignant colorectal obstruction,avoid emergent surgery,result in higher primary anastomosis rates,increase laparoscopic surgery rates and decrease osteomyelitis rates.It is also technically safe and simple strategy in malignant colonic obstruction for palliative treatment,which offers an improved quality of life.