Clinical effect of laparoscopic surgery on patients with colon cancer complicated with intestinal obstruction.
Efecto clínico de la cirugía laparoscópica en pacientes con cáncer de colon complicado con obstrucción intestinal.
Keywords:
colon cancer, intestinal obstruction, laparoscopic
Abstract
Colon cancer is a malignant tumor of the digestive tract, often complicated by intestinal obstruction. Laparoscopic surgery is widely used and has the advantages of a small postoperative wound, less intraoperative blood loss, and fewer postoperative complications. To measure the clinical effect of laparoscopic surgery on patients with colon cancer complicated with intestinal obstruction, the clinical data of 100 patients with this condition, who under- went surgical treatment in the Baoji High-tech Hospital between January 2020 and December 2022, were retrospectively analyzed. Based on different surgical methods, the patients were separated into a control group (CG, traditional lap- arotomy) and an observation group (OG, laparoscopic surgery). The total clini- cal effect of OG was superior to that of CG, as evidenced by shorter operation times, reduced intraoperative blood loss, faster recovery times for intestinal function, earlier discharge from bed, and shorter hospital stays. After surgery, the NRS score declined in both groups, with a lower score in the OG. TNF-α, IL -6, and CRP levels were elevated in both groups, but those in OG were lower. The occurrence of complications in the OG was reduced compared to the CG. Quality-of-life scores, including physical function, psychological state, social communication, and self-care ability in the OG, were higher than those in the CG. Laparoscopic surgery is effective for treating colon cancer complicated with intestinal obstruction in patients, which can effectively lessen their pain, reduce their inflammatory indicators, reduce the postoperative complications of patients, and improve their quality of life.
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References
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Nozawa H, Morikawa T, Kawai K, Hata K, Tanaka T, Nishikawa T, et al. Obstruction is associated with perineural invasion in T3/T4 colon cancer. Colorectal Dis. 2019;21(8):917-924. https://doi.org/10.1111/codi.14655.
Yang KM, Jeong MJ, Yoon KH, Jung YT, Kwak JY. Oncologic outcome of colon cancer with perforation and obstruction. BMC Gastroenterol. 2022;22(1):247. https://doi.org/10.1186/s12876-022-02319-5.
Jackson P, Vigiola Cruz M. Intestinal Obstruction: Evaluation and Management. Am Fam Physician. 2018;98(6):362-367. PMID: 30215917.
Han JG, Wang ZJ, Dai Y, Li XR, Qian Q, Wang GY, et al. Short-term outcomes of elective surgery following self-expandable metallic stent and neoadjuvant chemotherapy in patients with left-sided colon cancer obstruction. Dis Colon Rectum. 2023;66(10):1319-1328. https://doi.org/10.1097/DCR.0000000000002372.
Cao Y, Deng S, Wu K, Zheng H, Cheng P, Zhang J, et al. Oncological consequence of emergent resection of perforated colon cancer with complete obstruction after stent insertion as a bridge to surgery. Int J Colorectal Dis. 2019;34(3):545-547. https://doi.org/10.1007/s00384-018-3137-0.
Cirocchi R, Cesare Campanile F, Di Saverio S, Popivanov G, Carlini L, Pironi D, et al. Laparoscopic versus open colectomy for obstructing right colon cancer: A systematic review and meta-analysis. J Visc Surg. 2017; 154 (6):387-399. https://doi.org/10.1016/j.jviscsurg.2017.09.002.
Chen TM, Huang YT, Wang GC. Outcome of colon cancer initially presenting as colon perforation and obstruction. World J Surg Oncol. 2017;15(1):164. https://doi.org/10.1186/s12957-017-1228-y.
Adams K, Chapuis PH, Keshava A, Rickard M, Stewart P, Suen M, et al. Recurrence and colon cancer-specific death in patients with large bowel obstruction requiring urgent operation: a competing risks analysis. Colorectal Dis. 2021;23(10):2604-2618. https://doi.org/10.1111/codi.15807.
Li W, Jin X, Liang G. The efficacy of endoscopic stenting combined with laparoscopy in the treatment of left colon cancer with obstruction. J Cancer Res Ther. 2019;15(2):375-379. https://doi.org/10.4103/jcrt.JCRT_111_18.
Veld JV, Amelung FJ, Borstlap WAA, van Halsema EE, Consten ECJ, Siersema PD, et al. Dutch Snapshot Research Group. Comparison of Decompressing Stoma vs Stent as a Bridge to Surgery for Left-Sided Obstructive Colon Cancer. JAMA Surg. 2020;155(3):269. https://doi.org/10.1001/jamasurg.2020.0131.
Jensen KK, Andersen P, Erichsen R, Scheike T, Iversen LH, Krarup PM. Decreased risk of surgery for small bowel obstruction after laparoscopic colon cancer surgery compared with open surgery: a nationwide cohort study. Surg Endosc. 2016;30(12):5572-5582. https://doi.org/10.1007/s00464-016-4930-x.
Tamagawa H, Aoyama T, Numata M, Kazama K, Maezawa Y, Atsumi Y, et al. A Comparison of Open and Laparoscopic-assisted Colectomy for Obstructive Colon Cancer. In Vivo. 2020;34(5):2797-2801. https://doi.org/10.21873/invivo.12105.
Klaver CEL, Kappen TM, Borstlap WAA, Bemelman WA, Tanis PJ. Laparoscopic surgery for T4 colon cancer: a systematic review and meta-analysis. Surg Endosc. 2017;31(12):4902-4912. https://doi.org/10.1007/s00464-017-5544-7.
Shimizu H, Yamazaki R, Ohtsuka H, Osaka I, Takuma K, Morita Y. Feasibility of laparoscopic surgery after stent insertion for obstructive colorectal cancer. Asian J Endosc Surg. 2018;11(2):118-122. https://doi.org/10.1111/ases.12434.
Wang X, Ni H, Jia W, Wang S, Zhang Y, Zhao P, Yuan L. Value of different anastomoses in laparoscopic radical right hemicolectomy for right-sided colon cancer: retrospective study and literature review. World J Surg Oncol. 2022;20(1):318. https://doi.org/10.1186/s12957-022-02789-7.
Enomoto T, Saida Y, Takabayashi K, Nagao S, Takeshita E, Watanabe R, et al. Open surgery versus laparoscopic surgery after stent insertion for obstructive colorectal cancer. Surg Today. 2016;46(12):1383-1386. https://doi.org/10.1007/s00595-016-1331-7.
Udayasiri DK, Skandarajah A, Hayes IP. Laparoscopic Compared with Open Resection for Colorectal Cancer and Long-term Incidence of Adhesional Intestinal Obstruction and Incisional Hernia: A Systematic Review and Meta-analysis. Dis Colon Rectum. 2020;63(1):101-112. https://doi.org/10.1097/DCR.0000000000001540.
Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, et al. COlon cancer Laparoscopic or Open Resection Study Group (COLOR). Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477-484. https://doi.org/10.1016/S1470-2045(05)70221- 7. PMID: 15992696.
Feinberg AE, Valente MA. Elective Abdominal Surgery for Inflammatory Bowel Disease. Surg Clin North Am. 2019;99(6):1123- 1140. https://doi.org/10.1016/j.suc.2019.08.004.
Yamamoto T, Teixeira FV, Saad-Hossne R, Kotze PG, Danese S. Anti-TNF and Postoperative Complications in Abdominal Crohn’s Disease Surgery. Curr Drug Targets 2019;20(13):1339-1348. https://doi.org/10.2174/1389450120666190404144 048.
Kyrochristou I, Spartalis E, Anagnostopoulos G, Tsourouflis G, Dimitroulis D, Nikiteas NI. CRP in Drain Fluid as a Predictive Marker of Anastomotic Leak in Colorectal Surgery: A Systematic Review of the Literature. In Vivo. 2023;37(4):1450-1454. https://doi.org/10.21873/invivo.13229.
Klemt C, Padmanabha A, Esposito JG, Laurencin S, Smith EJ, Kwon YM. Elevated ESR and CRP Prior to Second-Stage Reimplantation Knee Revision Surgery for Periprosthetic Joint Infection Are Associated with Increased Reinfection Rates. J Knee Surg 2023;36(4):354-361. https://doi.org/10.1055/s-0041-1733902.
Kvarnström A, Swartling T, Kurlberg G, Bengtson JP, Bengtsson A. Pro-inflammatory cytokine release in rectal surgery: comparison between laparoscopic and open surgical techniques. Arch Immunol Ther Exp (Warsz). 2013;61(5):407-411. https://doi.org/10.1007/s00005-013-0239-9.
van der Pas MH, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WC, et al. COlorectal cancer Laparoscopic or Open Re-section II (COLOR II) Study Group. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14(3):210-218. https://doi.org/10.1016/S1470-2045(13)70016-0.
Holze S, Lemaire E, Mende M, Neuhaus P, Arthanareeswaran VK, Truss MC, et al. Quality of life after robotic-assisted and laparoscopic radical prostatectomy: Results of a multicenter randomized controlled trial (LAP-01). Prostate 2022;82(8):894- 903. https://doi.org/10.1002/pros.24332.
Published
2025-09-01
How to Cite
Wu, P., & Ta, Z. (2025). Clinical effect of laparoscopic surgery on patients with colon cancer complicated with intestinal obstruction.: Efecto clínico de la cirugía laparoscópica en pacientes con cáncer de colon complicado con obstrucción intestinal. Investigación Clínica, 66(3), 313-321. https://doi.org/10.54817/IC.v66n3a07
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Original Works
