Effects of laparoscopic surgery on gastrointestinal function,serum carcinoembryonic antigen and carbohydrate antigen 199 in patients with colon cancer and intestinal obstruction after self-expan-ding metal stent implantation
Objective To observe the effects of laparoscopic surgery on gastrointestinal function,serum carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)in patients with colon cancer and intestinal obstruction after self-expandable metal stent(SEMS)implantation.Methods A total of 89 patients with colon cancer and intestinal obstruction in the hospital were retrospectively collected be-tween December 2017 and December 2022.According to different timing of laparoscopic surgery,patients were divided into group A(laparoscopic surgery within ≤14 d after SEMS implantation,n=38)and group B(＞14 d,n=51).The intraoperative blood loss,operation time,number of lymph node dissection,hos-pitalization time,anal exhaust time,defecation time and eating liquid time were recorded.The levels of se-rum carbohydrate antigen 125(CA125),CEA and CA199 were detected by electrochemiluminescence im-munoassay at 5th d after surgery.The complications were statistically analyzed.The 1-year overall survival rate after surgery was followed up.The curves of total survival rates were drawn by Kaplan-Meier method.Log-rank test for statistical significance.Results There was no significant difference in intraoperative blood loss,operation time,number of lymph node dissection or hospitalization time between group A and group B[(58.76±6.03)vs.(59.84±6.11)ml,(118.72±28.53)vs.(118.72±28.53)min,11.77±2.53 vs.11.93±2.61,(7.74±1.33)d vs.(7.63±1.21)d,P＞0.05].The anal exhaust time,defecation time and eating liquid time in group A were(1.48±0.18),(5.23±0.63)and(5.12±0.68)d respectively,shorter than those in group B[(1.57±0.20),(5.94±0.74),(5.64±0.74)d,P＜0.05],and levels of serum CA125,CEA and CA199 were(31.58±3.45)U/ml,(4.35±0.51)ng/ml and(24.36±2.87)U/ml respectively,lower than those in group B[(36.77±3.71)U/ml,(4.63± 0.66)ng/ml,(28.96±3.11)U/ml,P＜0.05].There was no significant difference in total incidence of complications or 1-year overall survival rate between group A and group B(13.16％vs.15.69％,44.74％vs.49.02％,P＞0.05).Conclusion Compared with laparoscopic surgery within＞14 d after SEMS implantation,curative effect of laparoscopic surgery within ≤ 14 d after SEMS implantation is better in patients with colon cancer and intestinal obstruction,which can promote postoperative recovery and re-duce serum tumor markers,with low incidence of postoperative complications and certain safety.However,it has no obvious advantages in terms of short-term prognosis.
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