Analysis of the effect of emergency primary resection and anastomosis in the treatment of obstructive left hemicolon cancer and the value of preventing reoperation

Abstract

Objective To study and evaluate the clinical effect of emergency primary resection and anastomosis in the treatment of obstructive left hemicolon carcinoma and the value of preventing reoperation. Methods From February 1st 2013 to February 1st 2018, a total of 46 patients with obstructive left hemicolon cancer underwent surgical treatment were selected in the First People's Hospital of Jinzhong.According to the random digital table method, 46 patients with obstructive left colon cancer were randomly divided into two groups, with 23 patients in each group.The control group received stage colon resection and anastomosis, and the observation group received stage I resection and anastomosis.The operative condition, postoperative recovery, anastomotic leakage, therapeutic effect of intestinal obstruction, serum inflammatory cytokines and reoperation rate were compared between the two groups. Results There were no statistically significant differences in the number of lymph nodes dissection, the amount of blood lost during operation and time of operation (all P>0.05). The recovery time of anal exhaust[(2.34 ±0.86)d], the removal time of drainage tube[(4.36±1.52)d], the active time of getting out of bed [(3.81±1.17)d], the hospitalization time[(12.05 ±2.73)d] in the observation group were significantly shorter than those in the control group[(3.29±1.05)d, (6.17±1.84)d, (5.24±1.43)d, (15.76±3.69)d](t=3.357, 3.637, 3.712, 3.876, all P 0.05), and there was no statistically significant difference in the total effective rate of intestinal obstruction treatment between the two groups (P>0.05). The levels of serum inflammatory cytokines such as C-reactive protein, interleukin-6 and tumor necrosis factor-alpha in the two groups were significantly lower than those before operation(all P 0.05). The rates of reoperation in the observation group and control group were 8.70% and 4.35%, respectively, and there was no statistically significant difference between the two groups (P>0.05). Conclusion Stage I resection and anastomosis can be used to treat intestinal obstruction effectively, dissect lymph nodes, suppress inflammatory reaction, it is safe and reliable, and do not increase the risk of reoperation.Compared with stage I resection and anastomosis, it has more advantages in accelerating postoperative recovery, which is beneficial to reduce the cost of treatment and reduce the economic burden of patients. Key words: Intestinal obstruction; Colonic neoplasms; Gastroenterostomy; Anastomotic leak; Emergency treatment; Treatment outcome