Clinical Efficacy and Prognostic Factor Analysis of Different Surgical Ap-proaches in the Treatment of Left Colon Cancer Complicated with Acute Intestinal Obstruction
Clinical Efficacy and Prognostic Factor Analysis of Different Surgical Ap-proaches in the Treatment of Left Colon Cancer Complicated with Acute Intestinal Obstruction
Objective To compare clinical effects of two different surgical approaches in the treatment of left colon cancer complicated with acute intestinal obstruction(AIO),and to analyze the prognostic factors.Methods Clinical data of 102 patients with left colon cancer complicated with AIO admitted to the hospital from January 2020 to January 2023 were ret-rospectively analyzed.According to treatment methods,they were divided into control group and observation group,with 51 patients in each group.The control group underwent stageⅠresection and anastomosis of the left colon and proximal colosto-my,and the observation group underwent stage Ⅰ radical resection and anastomosis of the left colon.Duration of operation,intraoperative blood loss,time of gastric tube removal,length of hospital stay,time to first postoperative food intake,first anal exhaust time and defecation time were recorded in the two groups.The occurrence of complications such as incision bleeding,incision infection,abdominal infection and anastomotic fistula were recorded in the two groups during follow-up.Multivariate COX regression analysis was used to investigate the influencing factors of postoperative prognosis in patients with left colon cancer complicated with AIO.Results The duration of operation was shorter and intraoperative blood loss was less in the ob-servation group than in the control group,but the time of gastric tube removal,time to first postoperative food intake,the first anal exhaust time and the first defecation time were longer than those in the control group(P＜0.01).There was no signifi-cant difference in the total incidence of postoperative complications between the two groups[58.82%(30/51)vs.52.94%(27/51)](P＞0.05).The overall survival of 102 patients was 91.18%(93/102)at 1-year follow-up.Multivariate COX regression analysis showed that pathological type,TNM stage,postoperative adjuvant chemotherapy and surgical approach were the risk factors affecting the prognosis of patients with left colon cancer complicated with AIO(P＜0.05,P＜0.01).Conclusion Stage I radical resection and anastomosis has better clinical effect than stageⅠresection and anastomosis of the left colon and proximal colostomy in the treatment of left colon cancer complicated with AIO.However,stageⅠresection and anastomosis of the left colon and proximal colostomy can be performed in patients with poor systemic condition or high risk to reduce the risk of anastomotic fistula and postoperative complications.
关键词
结肠肿瘤/肠梗阻/肠吻合术/吻合近端造瘘术/手术后并发症/肿瘤分期/预后
Key words
Colonic neoplasms/Intestinal obstruction/Enterostomy/Anastomosis and proximal colostomy/Postoper-ative complications/Neoplasm staging/Prognosis
维普
万方数据