Comparison Of The Clinical Efficacy Of Obstructing Colon Cancer

Objective: Research background: Recent years the actual domesticmorbidity of colon cancer is higher than the morbidity of rectal cancer. Colon caner isbecoming the most common Intestinal Neoplasms. Among the complications of coloncancer, large bowel obstruction is of the highest incidence. In this dissertation, theclinical Efficacy of colon cancers with obstruction and with no obstruction arecompared, in order to discuss the perioperative, the chosen of treatment options, theprecaution of postoperation complication and efficacy of surgical treatment of coloncancer patients with obstructing.Method: Materials and Methods: Retrospective study is adopted in this study. We chose171cases by random from the medical records of all colon cancers patienetshospitalized from January of2010to November of2013in Second Hospital of DalianMedical University.61colon cancer patients with obstruction constitute theExperimental Group and110colon cancer patients with no obstruction belong to theControl Group. Statistical analyses were performed by SPSS13.0.P values less than0.05were considered significant difference. By survey of the patients of ExperimentalGroup and Control Group in pre-operation clinical physical examination data, CEA andpostoperation complication, etc, this dissertation try to analyze the difference betweencolon cancer patients with obstruction and patients in Control Group, as well as todiscuss the perioperative, the chosen of treatment options, the precaution ofpostoperation complication and efficacy of surgical treatment of colon cancer patientswith obstructing.Result: In this study,171colon cancer patients are selected and seperated as two groups.Experimental group includes61colon cancer patients with obstructing, of which theobstructing is3.8±2.9d (caculated from the anus stopping exhaust till beforeemergency operation). Control group includes110colon cancer patients with noobstruction. All patients have underwent operation of hemicolectomy aiming at Neoplasms.150of them underwent primary anastomosis, and other11patientsunderwent two-stage surgery. In the follow-up interview of patients in experimentalgroup who underwent two-stage surgery, it is found that one case was occuredanastomotic failure and fistula after two-stage surgery and was cured after conservertivetreatment.There are no significant difference between the cases of two groups in sex, age,underlying disease, ASA classification, TNM neoplasm staging, CEA, anastomoticfistula, reoperation, mortality rate etc (P＞0.05). In the study, it is found that there issignificant difference between the patients of experimental group and those of controlgroup in rate of poor wound healing (16.4%vs6.4％2=4.579, P=0.03),hospitalization(18.5±4.9d vs16.8±4.1d，P=0.024) and the operation time (172.7±33.0min vs198.3±37.2min，P=0.0001). After further study, it is found that when thetime of obstruction is over three days, the occurance rate of poor wound healing willincrease, which is of statistical significance (26.7％vs6.5%2=4.546, P=0.03). Forthe left-colon cancer patients in experimental group, there is no significant difference inthe rate of anastomotic fistula bewteen primary anastomosis cases and two cases (2=0.273，P=0.601).Conclusion: There is no significant difference in the anastomotic fistula morbiditybetween the two-stage surgery cases and primary anastomosis cases of colon patientswith obstruction. It’s safe and reliable to execute primary anastomosis when the patient’sstatus permits. In the Experimental Group, the probability of poor wound healing afteroperation of hemicolectomy is higher than those of the Control Group. The probabilityis even higher in the cases with obstructing for a long time. The operation time andhospitalization of Experimental Group is longer than those of Control Group.