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目的比较肠镜下金属支架(self-expanding metallic stents,SEMS)置入序贯手术与急诊手术(emergency surgery,ES)治疗梗阻性结直肠癌的远期肿瘤学效果。方法接受手术治疗的梗阻性结直肠癌病人60例。将60例病人分成两组,ES组33例,接受急诊手术治疗;SEMS组27例,接受非透视下SEMS置入序贯手术。比较两组病人临床病理特征及总体生存率。所有病人术前均由多学科团队讨论、制定治疗方案。结果两组病人一般资料、肿瘤分期、肿瘤部位等比较差异无统计学意义。SEMS组病人中位总体生存时间为37个月,ES组病人为23个月。SEMS组和ES组病人接受术后辅助化疗分别为70.4%和45.5%,术后3年总体生存率分别为55.6%和39.4%,5年总体生存率分别为48.1%和36.4%,两组比较差异均无统计学意义(P>0.05)。结论SEMS置入序贯手术治疗梗阻性结直肠癌安全、可行,远期肿瘤学结果有效。
Objective To compare the long-term oncology outcomes of sequential surgery and emergency surgery (ES) in the treatment of obstructive colorectal cancer with self-expanding metallic stents (SEMS). Methods Sixty patients with obstructive colorectal cancer undergoing surgery were enrolled. 60 patients were divided into two groups, ES group, 33 patients underwent emergency surgery; SEMS group of 27 patients, underwent non-fluoroscopic SEMS sequential surgery. The clinicopathological features and overall survival of the two groups were compared. All patients were discussed by a multidisciplinary team before surgery to develop a treatment plan. Results The two groups of patients with general information, tumor staging, tumor sites and other differences were not statistically significant. The median overall survival in the SEMS group was 37 months and in the ES group was 23 months. Postoperative adjuvant chemotherapy in the SEMS and ES groups was 70.4% and 45.5%, respectively, and the 3-year overall survival rates were 55.6% and 39.4% respectively. The 5-year overall survival rates were 48.1% and 36.4%, respectively There was no significant difference (P> 0.05). Conclusion SEMS insertion sequential surgery for obstructive colorectal cancer safe and feasible, long-term oncology results.