关键词:

结直肠癌, 内镜黏膜下剥离术, 曲安奈德, 肠道狭窄, 吞咽困难

Abstract:

Objective　To observe the application value of triamcinolone acetonide pretreatment assisted with endoscopic submucosal dissection (ESD) in the treatment of colorectal cancer and its prevention and treatment effect on intestinal stenosis. Methods　This was a prospective randomized controlled trial. This study selected 120 colorectal cancer patients admitted to Henan University Huaihe Hospital between June 2020 and October 2022 as the study subjects. By using the random number table method, 50 patients who only received ESD were included in the control group, and 70 patients who received triamcinolone acetonide pretreatment as an auxiliary ESD treatment were included in the observation group. In the control group, there were 30 males and 20 females, aged (65.25±5.31) years; in the observation group, there were 42 males and 28 females, aged (66.16±5.28) years. All patients were followed up for 6 months to compare the treatment status, postoperative complications, postoperative intestinal stenosis, postoperative recovery, and occurrence of adverse reactions between the two groups. Independent sample t test, χ² test, and rank sum test were used. Results　Under different treatment plans, the operation time of the observation group was (61.15±10.27) minutes, and there was no statistically significant difference compared to that of the control group [(58.44±10.26) minutes] (P>0.05). The number of repeated expansions in the observation group was (1.44±0.27), which was lower than that in the control group [(3.35±1.02)], and the interval between expansions in the observation group was (20.33±8.26) weeks, which was longer than that in the control group [(14.15±5.41) weeks], with statistically significant differences (t=14.972 and 4.626, both P<0.001). After treatment, the incidence of postoperative complications in the observation group was 7.14% (5/70), and the incidence of intestinal stenosis was 7.14% (5/70), which were both lower than those in the control group [20.00% (10/50) and 22.00% (11/50)], with statistically significant differences (χ²=7.050, P=0.008; Z=-2.360, P=0.018). After treatment, the excellent and good recovery rate of dysphagia in the observation group was 91.43% (64/70), higher than that in the control group [76.00% (38/50)], with a statistically significant difference (χ²=8.732, P=0.003). The incidence of adverse reactions in the observation group was 13.33% (4/70), and there was no statistically significant difference compared to that in the control group [6.00% (3/50)] (P>0.05). Conclusions　The use of triamcinolone acetonide pretreatment combined with ESD treatment can enhance the surgical efficacy, reduce the risk of repeated expansions, complications, and intestinal stenosis, and promote the postoperative recovery of dysphagia symptoms in patients. Triamcinolone acetonide is safe and does not significantly increase the risk of adverse reactions in patients.

Key words:

Colorectal cancer, Endoscopic submucosal dissection, Triamcinolone acetonide, Intestinal stenosis, Dysphagia