论文部分内容阅读
AIM:To investigate the clinical advantages of the stent-laparoscopy approach to treat colorectal cancer(CRC)patients with acute colorectal obstruction(ACO).METHODS:From April 2008 to April 2012,surgeryrelated parameters,complications,overall survival(OS),and disease-free survival(DFS)of 74 consecutive patients with left-sided CRC presented with ACO who underwent self-expandable metallic stent(SEMS)placement followed by one-stage open(n=58)or laparoscopic resection(n=16)were evaluated retrospectively.The stent-laparoscopy group was also compared with a control group of 96 CRC patients who underwent regular laparoscopy without ACO between January 2010 and December 2011 to explore whether SEMS placement influenced the laparoscopic procedure or reduced long-term survival by influencing CRC oncological characteristics.RESULTS:The characteristics of patients among these groups were comparable.The rate of conversion to open surgery was 12.5%in the stent-laparoscopy group.Bowel function recovery and postoperative hospital stay were significantly shorter(3.3±0.9 d vs 4.2±1.5 d and 6.7±1.1 d vs 9.5±6.7 d,P=0.016 and P=0.005),and surgical time was significantly longer(152.1±44.4 min vs 127.4±38.4 min,P=0.045)in the stent-laparoscopy group than in the stent-open group.Surgery-related complications and the rate of admission to the intensive care unit were lower in the stent-laparoscopy group.There were no significant differences in the interval between stenting and surgery,intraoperative blood loss,OS,and DFS between the two stent groups.Compared with those in the stentlaparoscopy group,all surgery-related parameters,complications,OS,and DFS in the control group were comparable.CONCLUSION:The stent-laparoscopy approach is a feasible,rapid,and minimally invasive option for patients with ACO caused by left-sided CRC and can achieve a favorable long-term prognosis.