Efficacy and safety of combining intestinal stenting with laparoscopic surgery in colorectal cancer patients with acute intestinal obstruction.

Abstract

Background: Recently, intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction. However, its safety and efficacy have not yet been established.

Aim: To assess the efficacy and safety of combining intestinal stenting with laparoscopic surgery for the management of acute intestinal obstruction.

Methods: Clinical data from 74 patients with colorectal cancer and acute intestinal obstruction, who were admitted to the emergency department of the authors' hospital between October 2023 and November 2024, were collected and analyzed. Patients were divided into two groups based on the surgical intervention: A control group (emergency open surgery, n = 37) and a study group (intestinal stent implantation combined with laparoscopic surgery, n = 37). Observation indicators included stent placement rate, obstruction relief rate, and stent-related complications.

Results: Intestinal stent placement was 100% successful in the study group, all of whom experienced relief from obstruction while exhibiting a significantly lower rate of ostomy creation and a higher rate of primary anastomosis than in the control group, as well as less intraoperative blood loss, shorter time to flatus, and shorter hospital stay. The complication rate was 5.41% (2/37; bleeding and re-obstruction), with no statistically significant difference between the two groups in terms of operative duration or perioperative mortality. The overall complication rates were 5.41% (2/37) and 21.62% (8/37) in the intervention and control groups, respectively. Tumor recurrence and overall survival rates were 2.70% and 97.30% in the study group and 13.51% and 91.89% in the control group, respectively.

Conclusion: Intestinal stenting relieved acute obstructions, reduced the number of emergency surgeries, and supported laparoscopic procedures while improving primary anastomosis rates, minimizing ostomy occurrence, surgical trauma, and complications, and accelerating recovery.