Comparison Of Clinical Efficacy Of Intestinal Stenting Combined With Elective Surgery And Emergency Surgery In Obstructive Colorectal Cancer

Objective: To compare the clinical efficacy of intestinal stent placement combined elective surgery and emergency surgery for treatment of obstructive colorectal cancer.Methods: To collect retrospectively the clinical data of 104 patients who were diagnosed colorectal cancer with acute intestinal obstruction in the affiliated Shengjing Hospital of China Medical University from January 1,2012 to January 31,2016.According to different treatment plans,the patients were divided into two groups: intestinal stent placement combined elective surgery(stenting group,SG)and emergency surgery immediately(emergency surgery group,EG).Intraoperative data(whether the patients were in laparoscopic surgery,surgery time,intraoperative bleeding volume,intraoperative lymph node dissection,stoma rate),postoperative complications(anastomotic leak/closed leak,abdominal infection,incision infection,respiratory or urinary tract infection,cardiovascular and cerebrovascular complications,venous embolism),and postoperative recovery(whether the patients were transferred to ICU,postoperative exhaust time,postoperative days,perioperative mortality,total hospitalization and overall survival time)were collected.SPSS25.0 was used for statistical analysis.Results:104 patients diagnosed colorectal cancer with acute intestinal obstruction were included,54 patients of SG and 50 patients of EG,53males(51%)and 51 females(49%)with average age(67.72±11.615),the success rate of stent placement technique was 96.43%(54/56 cases,two cases of failure turned to emergency surgery),the complication rate(6/56,11.1%,all mild complications,improved after conservative treatment),and the clinical remission rate was 100%.SG and EG in operation time,intraoperative bleeding volume,intraoperative lymph node dissection,stoma rate,postoperative complications(anastomotic leak/ closed leak,celiac infection,incision infection,respiratory or urinary tract infection,cardiovascular and cerebrovascular complications,venous embolism),perioperative mortality,rate of transfer to ICU after surgery,postoperative exhaust time,postoperative hospitalization days,oneyear survival rate,three-year survival rate were not significant statistically different(P >0.05).The rate of SG laparoscopic surgery(40/54,74.1%)was higher than that of EG(4/50,8%),and the difference was statistically significant(P <0.05).The cost of EG hospitalization(median 78491.47)was higher than that of SG(median 56084.04),and the difference was statistically significant(P <0.05).The two-year survival rate of EG(81.5%)was significantly higher than that of SG(62%),and the difference was statistically significant(P <0.05).Conclusion: In this study,there was no significant difference in the incidence of postoperative complications between EG and SG.And there was no significant difference in the time of operation,the amount of intraoperative bleeding,the number of lymph nodes dissected during operation,the rate of stoma,the perioperative mortality,rate of transfer to ICU after surgery,postoperative exhaust time,postoperative hospitalization days,oneyear survival rate,three-year survival rate too.The rate of EG laparoscopic surgery was significantly higher than that of SG,but the cost of hospitalization was also higher,and the two-year survival rate was higher than that of EG group.The clinical efficacy of intestinal stenting combined elective surgery is better than emergency surgery immediately in patients with obstructive colorectal cancer.