[A preliminary study of stenting followed by laparoscopic surgery for obstructing left-sided colon cancer].
摘要
OBJECTIVE: To study the efficacy of stenting followed by laparoscopic surgery in the treatment of obstructing left-sided colon cancer. METHODS: Forty-nine patients with obstructing left-sided colon cancer were prospectively randomized into two groups. Twenty patients received emergent open surgery, while 15 underwent laparoscopic surgery 3 days after placement of the self-expanding metal stent (SEMS) and 14 of them received laparoscopic surgery 10 days after placement of SEMS. Outcomes evaluated included 1-stage operation rate, conversion rate, operative time, length of hospital stay, blood loss, postoperative pain score and use of analgesics, rates of permanent stoma, and postoperative complications. RESULTS: Compared with emergent open surgery, patients undergoing laparoscopic surgery had significantly less blood loss(P=0.000), lower permanent stoma rate (P=0.024), less pain(P=0.000), and lower incidence of postoperative complications. Laparoscopic surgery was associated with a significantly higher rate of 1-stage operation(P=0.004). Compared with patients undergoing laparoscopic surgery 3 days after SEMS placement, patients who underwent laparoscopic surgery 10 days after SEMS placement had a significantly higher 1-stage operation rate(P=0.001) and a lower conversion rate(P=0.046). CONCLUSIONS: Self-expanding metal stenting is a safe and effective bridge to laparoscopic surgery in patients with obstructing left-sided colon cancer. Laparoscopic surgery 10 days after SEMS placement may be more appropriate.