Efficacy and safety of placing self-expanding metallic stent bridging surgery for obstructive colon cancer
10.3760/cma.j.cn115355-20231110-00183
- VernacularTitle:置入自膨式金属支架桥接手术治疗梗阻性结肠癌的效果及安全性
- Author:
Qiang WEI
1
;
Xinxuan ZHAO
;
Jian MA
;
Haiyi LIU
Author Information
1. 山西医科大学第二临床医学院，太原 030000
- Keywords:
Colon neoplasms;
Intestinal obstruction;
Self-expanding metallic stent;
Surgical procedures, operative;
Emergency treatment
- From:
Cancer Research and Clinic
2024;36(7):519-524
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and safety of placing self-expanding metallic stent (SEMS) and emergency surgery in treatment of patients with obstructive colon cancer.Methods:A retrospective cohort study was conducted. The clinical data of 111 colon cancer patients with obstruction admitted to Shanxi Province Cancer Hospital from January 2017 to April 2020 were retrospectively analyzed, and all patients were divided into the emergency group (44 cases receiving emergency radical surgery) and the stenting group (67 cases receiving elective radical surgery after intra-intestinally placing SEMS). General data, operation-related indexes and postoperative recurrence and metastasis of both groups were compared. The Kaplan-Meier method was used for survival analysis, and Cox proportional risk model was used to analyze the factors influencing the prognosis.Results:Among 111 patients, 69 cases were male and 42 cases were female; the age was (61±13) years. There were not statistically significant differences in the general data between the emergency group and the stenting group (all P > 0.05). The proportion of patients receiving laparoscopic surgery in the stenting group was higher than that in the emergency group [32.84% (22/67) vs. 6.82% (3/44), P = 0.001]; the proportion of patients with the detected number of lymph nodes ≥12 in the stenting group was higher than that in the emergency group [94.03% (63/67) vs.79.55% (35/44), P = 0.020]; the proportion of patients with stoma prevention in the emergency group was higher than that in the stenting group [36.36% (16/44) vs. 17.91% (12/67), χ2 = 4.80, P = 0.029], and the duration of postoperative hospitalization in the emergency group was longer than that in the stenting group [14.0 (10 d, 17 d) vs. 11 d (10 d, 14 d), Z = -2.004, P = 0.045]. There were no statistically significant differences in postoperative pathological TNM staging, vascular infiltration, nerve invasion, local recurrence and distant metastasis between the 2 groups (all P > 0.05). The difference in 3-year disease-free survival rate was statistically significant between the emergency group and the stenting group (52.3% vs. 64.2%, χ2 = 2.2, P = 0.142), and difference in 3-year overall survival rate was statistically significant between the emergency group and the stenting group (56.8% vs. 73.1%, χ2 = 3.02, P = 0.087). The multivariate Cox regression analysis showed that tumor location, TNM staging, and vascular infiltration were independent influencing factors for 3-year disease-free survival of patients with obstructive colon cancer (all P < 0.05); age, tumor location, TNM staging, and vascular infiltration were independent influencing factors for 3-year overall survival of patients with obstructive colon cancer (all P < 0.05). Conclusions:Compared with emergency surgery, placement of SEMS bridging surgery for obstructive colon cancer is safe and reliable, and tumor location, TNM staging, and vascular infiltration are closely related to prognosis.
