Comparison Of Efficacy Of Laparoscopic Surgery For Colorectal Cancer With Obstruction At Different Time After Stent Implantation

ObjectiveTo analyze and compare the intraoperative and postoperative clinical indicators of laparoscopic radical tumor resection at different times for patients with left colon cancer and rectal cancer combined with ileus after colon stent operation,and to explore the best operative timing for such patients.MethodsRetrospective analysis was performed on the clinical data of 51 patients diagnosed with left colon and rectal cancer combined with ileum obstruction on January 1,2015 and December 31,2020 in the Liaoning Provincial People’s Hospital,who were scheduled to undergo laparoscopic radical tumor resection in the Gastrointestinal Department of the Liaoning Provincial People’s Hospital after the completion of metal stent implantation.Patients included in this study were divided into the following two groups according to the different time of laparoscopic radical tumor resection after colon stenting.Group A For 8 to 14 days after colon stent adept laparoscopic radical tumor patients,group B for 15 to 21 days after the colon stent adept laparoscopic radical tumor patients,statistical method is applied to analysis and comparison of the two groups of patients laparoscopic radical tumor operation time,intraoperative blood loss,intraoperative insufflate the incidence of edema,intraoperative preventive colostomy rate,the first defecation time and postoperative hospital stay,postoperative incidence of related complications,mortality and other indicators,and then draw relevant conclusions,clear the best time of operation for such patients.Colon stenting method: after local anesthesia in patients with left side,endoscopic doctor of anus mouth into the mirror,until the lens barrel through lumen obstruction caused by neoplasm,apply adequate amount to the mass biopsy,then through endoscopy tong road in the thread,imaging the surface markers under the intestinal stenosis site perspective,by endoscopic clamp passage along a colon metal stents,over the guidewire will metal stents placed in narrow lumen part of central area,and release the stents,stents release visible after the success of intestinal contents through unobstructed,exit the colonoscopy,can have intestinal contents anal mouth eduction.ResultsA total of 51 patients were included in this study,with an average age of73.61±9.20 years(54-91 years).There were 31 male patients(60.78%)and 20 female patients(39.22%).Among the 51 patients,26 were in group A,whose tumor sites included descending colon in 9 patients,sigmoid colon in 12 patients,and high rectum in 5 patients.The remaining 25 were in group B,whose tumor sites included descending colon in 10 patients,sigmoid colon in 9 patients,and high rectum in 6 patients.1.Comparison of intraoperative conditions between the two groups: although the operative time and blood loss in group A were superior to those in group B,there was no statistical significance(P > 0.05).However,there was no significant difference in the incidence of intestinal edema and the rate of preventive and protective stoma.2.Comparison of postoperative conditions between the two groups: the first postoperative defecation time and total postoperative hospitalization days in group A(laparoscopic radical resection of left colon cancer within 8-14 days after colon stenting)were lower than those in group B(laparoscopic radical resection of left colon cancer within 15-21 days after colon stenting),with statistical significance(P < 0.05).There was no significant difference in the incidence of postoperative complications between group A and group B.ConclusionPatients of group A(line 8 to 14 days after stent laparoscopic colon cancer radical prostatectomy)and group B patients(15 to 21 days after colon stent)of laparoscopic colon cancer radical in the art of the indicators(such as the operation time,blood loss,insufflate rate of edema,preventive colostomy rate,etc.)and the incidence of postoperative complications,no statistically significant differences.The postoperative hospitalization days and the first postoperative defecation days of patients in group A were less than those in group B,that is,the intestinal and systemic conditions of patients in group A could recover better and faster.The results of this study suggest that laparoscopic radical tumor resection within 8-14 days after colon stent surgery for patients with left colon and rectal cancer with obstruction is more effective than that within 15-21 days,which is more conducive to the recovery of patients and is worthy of clinical recommendation.