Clinical Analysis On Perioperative Treatment Of Obstructive Colorectal Cancer By Sequential Surgery With Colon Stent

Objective:To compare the peri-operative clinical effectiveness between stent sequential(SS)surgery with a colonic stent implantation and an emergency operation for the treatment of acute obstructive colorectal cancer.Methods: A retrospective analysis of 137 patients with acute obstructive colorectal cancer treated by colorectal surgery in XX Hospital from March 2014 to September 2019;of them,90 were colon stent implantation(35 were missing and 55 were treated by SS surgery);and 47 were treated by emergency surgery.All patients were preoperatively discussed by a multidisciplinary team to develop a treatment plan.the age,sex,pathological type,clinical stage,anastomosis rate of primary resection,preventive ileostomy rate,colostomy rate,laparoscopic operation rate,incidence of postoperative complications,icu transfer rate,number of lymph node dissection,median survival time were compared and analyzed in 2 groups.Results:(1)No significant difference in the parameters evaluated was found between the SS and emergency operation groups.(2)The SS surgery group had significantly higher one-stageresection and anastomosis rates compared with the emergency operation group(92.7%,51/55 vs 23.4%,11/47,P<0.05).(3)Compared with the emergency operation group,the ss operation group significantly reduced the rate of prophylactic ileostomy(17.6%,9/51 vs 63.6%,7/11,P<0.05)? colostomy(7.3%,4/55 vs 80.9%,38/47,P<0.05)? conversion to icu(5.5%,3/55 vs 383%,18/47,P<0.05)? Incidence of complications(18.2%,10/55 vs 40.4%,19/47,P<0.05).(4)Compared with the emergency operation group,SS operation group significantly increased the rate of laparoscopic surgery(87.3%,48/55 vs 4.3%,2/47,P <0.05)?the number of lymph node dissection(16.9±7.5 vs 11.7±11.0,P<0.05)? median survival time(38.6 months vs 37.months,P<0.05).Conclusions:1.Sequential operation of colon stent placement is an effective method for the treatment of acute obstructive colorectal cancer and has good perioperative clinical efficacy and clinical application value.2.Sequential operation of colon stent placement has better clinical efficacy and safety than emergency surgery in perioperative period.