To evaluate the feasibility and safety of colon stenting as bridge surgery for colorectal cancer obstruction. Methods: A total of 30 patients (stent group), who underwent colonic stenting for colorectal obstruction at the Third Xiangya Hospital, Central South University from September 2015 to June 2017, were selected to receive the preoperative bridge surgery. Technical success rates, clinical success rates, and stent-related complications were observed. A total of 38 patients (emergency surgery group), who underwent surgical operation for colorectal obstruction, served as a control. The tumor resection rate at Stage I, ostomy rate, hospitalization time, and hospitalization cost were compared between the 2 groups. Results: The technical success and clinical success rates were 100.0% and 90.0% in the stent group, respectively. The stent-related complications included bleeding in 2 cases (6.7%), micro-perforation in 1 case (3.3%), stent displacement in 1 case (3.3%), and stent occlusion in 3 cases (10.0%) in the stent group. The Stage I tumor resection rate in the stent group was significantly higher than that in the emergency surgery group (90.0% vs 68.4%, P<0.01). The incidence of anastomotic leakage in the stent group was lower than that in the emergency surgery group (3.3% vs 10.5%, P<0.05); the stoma rate in the stent group was lower than that in the emergency surgery group (13.3% vs 44.7%, P<0.01). The surgical complications occurred in the stent group were significantly lower than those in the emergency surgery group (20.0% vs 47.3%, P<0.01). The average hospital stay in the stent group was lower than that in the emergency surgery group (20.0 vs 24.5 days, P<0.05). There was no significant difference in hospitalization costs between the 2 groups (P>0.05). Conclusion: Preoperative colonic stenting for colorectal obstruction surgery as a bridge is feasible in terms of methods, and which can significantly increase the Stage I tumor resection rate, reduce the ostomy rate, decrease surgical complications, shorten the average length of hospital stay, and reduce patient suffering.
目的：评价结直肠癌性梗阻支架置入术作为外科手术前桥梁手术的可行性及安全性。方法：选择2015年9月至2017年6月在中南大学湘雅三医院因结直肠癌性梗阻行结肠支架置入术作为外科手术前桥梁手术的30例患者(支架组)，观察技术成功率、临床成功率及支架相关并发症，并与同期结直肠癌性梗阻急诊行外科手术的38例患者(急诊手术组)比较，观察I期肿瘤切除率、造口率、住院时间及住院费用等指标。结果：支架组30例患者技术成功率为100.0%，临床成功率为 90.0%。支架组并发症包括出血2例(6.7%)，术中发现微穿孔1例(3.3%)，支架移位1例(3.3%)，支架置放后再闭塞3例(10.0%)。支架组I期肿瘤切除率明显高于急诊手术组(分别为90.0%和68.4%，P<0.01)。支架组吻合口瘘发生率低于急诊手术组(分别为3.3%和10.5%，P<0.05)；支架组造口率低于急诊手术组(分别为13.3%和44.7%，P<0.01)；支架组手术相关并发症发生率明显低于急诊手术组(分别为20.0%和47.3%，P<0.01)。支架组平均住院日低于急诊手术组(分别为20.0 d和24.5 d，P<0.05)。两组住院费用相比差异无统计学意义(P>0.05)。结论：结直肠癌性梗阻外科手术前置入结肠支架作为桥梁手术在方法上切实可行，且能明显提高I期肿瘤切除率，减少造口率，降低手术相关并发症，缩短平均住院日，患者痛苦少。.