肠道支架联合手术治疗老年左半结肠癌合并急性肠梗阻的近期临床疗效分析

doi:10.3969/j.issn.1003-9198.2025.12.014

摘要/Abstract

摘要： 目的探讨肠道支架联合限期手术治疗老年左半结肠癌合并急性肠梗阻的近期疗效与安全性。方法采用回顾性分析法,选取2021年12月至2024年10月北京丰台右安门医院普通外科收治的75例老年左半结肠癌合并急性肠梗阻患者为研究对象。依据治疗方式将其分为2组,观察组(34例)行肠道支架置入+限期手术,对照组(41例)行急诊手术。比较2组患者围手术期临床指标的差异。结果 2组患者基线资料差异无统计学意义(P＞0.05),具有可比性。围手术期无死亡及吻合口漏病例。观察组在手术时间、手术方式、淋巴结清扫数目、结肠造瘘率、预防性回肠造瘘率、并发症发生率方面均优于对照组,差异有统计学意义(P＜0.05)。观察组住院费用高于对照组,差异具有统计学意义(P＜0.05)。2组术中出血量及术后进食时间比较,差异无统计学意义(P＞0.05)。结论对于老年左半结肠癌合并急性肠梗阻患者,采用肠道支架联合限期手术较急诊手术相比,能够缩短手术时间、增加腹腔镜手术机会、降低造瘘率,从而改善患者生活质量,近期疗效显著,值得临床推广应用。

关键词: 肠道支架, 老年人, 左半结肠癌, 急性肠梗阻, 限期手术, 急诊手术

Abstract: Objective To explore the safety and short-term efficacy of intestinal stent combined with elective surgery for elderly patients with left colorectal cancer and acute intestinal obstruction. Methods A retrospective analysis was conducted on 75 elderly patients with left colorectal cancer and acute intestinal obstruction who underwent surgery at Department of General Surgery, Beijing Fengtai You’anmen Hospital form December 2021 to October 2024. Based on the treatment approach, the patients were divided into two groups. The observation group (n=34) underwent intestinal stenting as a bridge to elective surgery, and the control group (n=41) underwent direct emergency surgery. The perioperative clinical outcomes were compared between the two groups. Results The baseline characteristics of the two groups were comparable (P>0.05). No perioperative death or anastomotic leakage was observed in both groups. The observation group showed superior outcomes compared to the control group in surgical duration, surgical approach, lymph node dissection count, colostomy rate, prophylactic ileostomy rate, and complications incidence (P<0.05). The total hospitalization cost was significantly higher in the observation group than that in the control group (P<0.05). There were no significant differences between the two groups in intraoperative blood loss and postoperative feeding time (P>0.05). Conclusions For elderly patients with left colorectal cancer and acute intestinal obstruction, intestinal stent combined with time-limited surgery can shorten the surgical duration, increase the laparoscopic operation opportunity, reduce the colostomy rate, and improve the quality of life of the patients. The short-term efficacy is significant, which is worthy of clinical promotion and application.

Key words: intestinal stent, aged, left colorectal cancer, acute intestinal obstruction, elective surgery, emergency operation

中图分类号:

R 735.35

张骏, 康健. 肠道支架联合手术治疗老年左半结肠癌合并急性肠梗阻的近期临床疗效分析[J]. 实用老年医学, 2025, 39(12): 1259-1262.

ZHANG Jun, KANG Jian. Short term clinical efficacy analysis of intestinal stent combined with surgery for elderly patients with left colon cancer complicated by acute intestinal obstruction[J]. Practical Geriatrics, 2025, 39(12): 1259-1262.

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