自扩张金属支架和左侧恶性结直肠阻塞手术之间的不同时间间隔的短期影响
Jiawei Zhang1,2, Mingli Su1,2, Dezheng Lin1,2
1Department of Endoscopic Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Frontiers in gastroenterology (Lausanne, Switzerland)
|March 13, 2026
概括
自扩张金属支架 (SEMS) 放置和左侧恶性结直肠阻塞 (LMCO) 手术之间的更长的间隔 (> 4 周) 可以改善短期结果. 这种延长的时间,包括新辅助化疗,减少并发症和住院时间.
科学领域:
- 结肠直肠外科手术是什么意思
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
背景情况:
- 在左侧恶性结直肠阻塞 (LMCO) 中放置自扩张金属支架 (SEMS) 后进行手术的最佳时间受到争议.
- 肠和瘤透等因素使手术规划复杂化.
- 与潜在的瘤进展平衡减少并发症至关重要.
研究的目的:
- 为了比较短期的术后并发症间隔≤4周和>4周的SEMS安置之后的手术.
- 评估新辅助化疗在延长间隔内对手术结果的影响.
主要方法:
- 在2012-2021年期间,对148名LMCO患者接受SEMS治疗的回顾性分析.
- 主要结局:短期的临床术后并发症 (Clavien-Dindo等级≥II).
- 在SEMS安置后进行手术的患者之间的比较 ≤4周 (组1) 和>4周 (组2).
主要成果:
- 间隔超过4周的患者 (2组) 的术后并发症显著减少 (2.3%对14.4%,p=0.040).
- 第二组还显示,术后肠功能恢复改善 (p<0.001),术后住院时间缩短 (p=0.028),总住院时间减少 (p=0.002).
结论:
- 在SEMS安置和LMCO手术之间超过4周的间隔与更好的短期临床结果有关.
- 这种延长的间隔,包括新辅助化疗,似乎有利于患者的康复.
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