The Journal of Practical Medicine ›› 2022, Vol. 38 ›› Issue (1): 79-84.doi: 10.3969/j.issn.1006⁃5725.2022.01.015

• Clinical Research • Previous Articles     Next Articles

The efficacy of elective surgery after stent implantation versus that of emergency surgery for acute malig⁃ nant obstruction of the right hemicolon

LI Pengli*,SHI Ding.   

  1. He′nan University of Chinese Medicine,Zheng⁃ zhou 450046,China

  • Online:2022-01-10 Published:2022-01-10
  • Contact: SHI Ding E⁃mail:shidingyuhang@163.com

Abstract:

Objective The purpose of this study was to compare the clinical value and long⁃term progno⁃ sis of elective surgery after stent implantation with those of emergency surgery in the treatment of acute malignant obstruction of the right hemicolon. Methods 25 patients who had undergone elective surgery after stenting for acute malignant obstruction of right hemicolon from January 2010 to May 2018 in Ningbo Huamei Hospital,Univer⁃ sity of Chinese Academy of Sciences were selected as a case group(stent group). Age,gender,tumor size and loca⁃ tion and TNM stage were used as the baseline characteristics of patients. The 1∶2 nearest neighbor⁃matching meth⁃ od was used to match 230 patients who had received emergency surgery for acute malignant obstruction of the right colon during the same period,which balanced the covariates in the two groups. After being matched via propensity score,50 patients were included in an emergency operation group. Results The technical success rate of stent implantation for acute malignant obstruction of the right hemicolon was 100% while the clinical success rate was 96.0%. The proportion of laparoscopic surgery was significantly higher but the surgical duration was markedly shorter in the stent group than in the emergency operation group(< 0.05). As compared with the emergency operation group,the incidence of postoperative complications and the length of postoperative hospital stay were significantly reduced in the stent group(< 0.05). There were no significant differences in 30⁃day mortality,5⁃year disease⁃free survival and overall survival between the two groups(> 0.05). Conclusions Stent implantation is safe and feasible in the treatment of acute malignant obstruction of the right hemicolon. As a bridge of surgery,stent implan⁃ tation can increase the chance of minimally invasive surgery for patients with acute right hemicolon malignant obstruction,shorten the surgical duration and the length of hospital stay,and reduce the incidence of complications. It can be used as an option for the treatment of acute right hemicolon obstruction.

Key words:

stent, right colon cancer, acute intestinal obstruction, elective surgery, emergency surgery