Clinical Efficacy of Transnasal Intestinal Obstruction Catheters in Patients with Right colon Cancer and Acute Intestinal Obstruction

Clinical Efficacy of Transnasal Intestinal Obstruction Catheters in Patients with Right colon Cancer and Acute Intestinal Obstruction | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Efficacy of Transnasal Intestinal Obstruction Catheters in Patients with Right colon Cancer and Acute Intestinal Obstruction Jingyou Ma, Jinpeng Zhen, Ningbao Yang, Yanjun Lian This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7841921/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 21 You are reading this latest preprint version Abstract Objective To evaluate the efficacy of laparoscopic right hemicolectomy following nasojejunal decompression in patients with right hemicolonic cancer complicated by intestinal obstruction. Methods A retrospective analysis was conducted on 56 patients with right hemicolonic cancer and acute intestinal obstruction admitted to our hospital. Thirty-two patients underwent laparoscopic-assisted right hemicolectomy after nasojejunal tube decompression (study group), while 24 patients underwent conventional open right hemicolectomy (control group). The two groups were compared in terms of operative time variation, intraoperative blood loss, number of lymph nodes dissected, time to first flatus, length of hospital stay, and postoperative complications. Results The baseline characteristics of patients in both the study group and control group were comparable. Compared with the control group, the study group exhibited lower intraoperative blood loss (t=-7.673, P < 0.001), faster postoperative anal gas passage time (t=-3.796, P < 0.001), and longer operative duration (t = 4.350, P 0.67) or length of hospital stay (t = 0.821, P > 0.41). The incidence of early postoperative complications was 3.13% and 29.16%, respectively, with no statistically significant difference (P < 0.004).Conclusion: For patients with right-sided colon cancer complicated by acute intestinal obstruction, performing laparoscopic-assisted right hemicolectomy with primary intestinal anastomosis within a limited timeframe following nasojejunal tube placement for intestinal decompression effectively addresses the issue of limited operative space during laparoscopy. This approach demonstrates clinical value in reducing intraoperative bleeding, promoting postoperative gastrointestinal function, and decreasing postoperative complications. Clinical Efficacy Intestinal obstruction Preoperative decompression Right hemicolon cancer Transnasal Intestinal Obstruction Catheters Laparoscopic right hemicolectomy Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Laparoscopic radical resection for colorectal cancer offers advantages such as minimally invasive procedures, reduced postoperative pain, faster recovery of bowel function, and shorter hospital stays. Studies have demonstrated that laparoscopic surgery yields comparable or superior outcomes to open surgery [ 1 – 2 ] . However, some patients with advanced colon cancer present with acute intestinal obstruction [ 3 ] , precluding routine preoperative preparation and necessitating emergency surgery. Due to intestinal dilation reducing operative space within the abdomen, laparoscopic procedures often prove unfeasible, requiring conversion to traditional open surgery. This approach involves greater surgical trauma and slower recovery. Furthermore, the larger incision increases susceptibility to wound infection and delayed healing, potentially compromising subsequent comprehensive treatment.Since 2020, the Gastrointestinal Surgery Department of Xingtai Central Hospital has performed laparoscopic-assisted right hemicolectomy with intestinal decompression via nasojejunal tube placement at the terminal ileum or ascending colon in 32 patients with right hemicolonic cancer complicated by acute intestinal obstruction. followed by laparoscopic-assisted right hemicolectomy. Compared with 24 concurrent cases undergoing conventional open right hemicolectomy for colon cancer, this approach was clinically feasible with satisfactory outcomes. Specific surgical procedures adhered to relevant guidelines and protocols [ 4 – 5 ] . The findings are reported below. 1 Materials and Methods 1.1 General Information Clinical data were collected from 56 patients with right-sided colon cancer complicated by acute intestinal obstruction admitted to the Department of Gastrointestinal Surgery, Xingtai Central Hospital, Hebei Province, between January 2020 and December 2024. Inclusion Criteria: (1) Preoperative abdominal contrast-enhanced CT clearly demonstrated the lesion location in the ileocecal region to the hepatic flexure of the colon, accompanied by complete intestinal obstruction; (2) No distant organ metastasis; (3) Postoperative pathological staging of the tumor was Stage II to III; (4) Postoperative pathology confirmed colon adenocarcinoma; (5) No contraindications for laparoscopic surgery. Exclusion criteria: (1) History of prior abdominal surgery or significant intraoperative abdominal adhesions; (2) Distant tumor metastasis; (3) Preoperative evidence of tumor perforation, peritonitis, or unresectable tumor; (4) Severe cardiopulmonary or renal dysfunction; (5) Advanced age or inability to tolerate endoscopic procedures.A total of 23 males and 33 females aged 42 to 75 years were included. Tumors were located in the hepatic flexure of the colon in 22 cases, the ascending colon in 15 cases, and the ileocecal region in 19 cases. Patients were divided into two groups: the study group (n = 32) underwent laparoscopic surgery after transnasal intestinal obstruction catheter placement, while the control group (n = 24) received emergency traditional open surgery upon admission. The study protocol was approved by the Medical Ethics Committee of Xingtai Central Hospital, and all patients signed informed consent forms. 1.2 Surgical Procedures Both groups received supportive treatment upon admission, including fasting with water, parenteral nutrition, anti-infective therapy, fluid replacement, correction of anemia, and correction of electrolyte imbalances. A cleansing enema was administered preoperatively, and all patients underwent radical resection. The study group underwent endoscopic placement of a nasojejunal obstruction catheter into the duodenum or upper jejunum under direct endoscopic visualization (Fig. 2). Utilizing the self-gravity of the catheter's tip balloon, the nasojejunal obstruction catheter advanced distally into the small intestine with gastrointestinal peristalsis, positioning it as close as possible to the obstruction site. After 24 hours, gastrointestinal contrast studies confirmed placement of the nasojejunal tube in the terminal ileum or ascending colon, enabling continuous suction decompression of the small intestine and right colon. Once abdominal pain and distension resolved, patients underwent scheduled laparoscopic right hemicolectomy. Control group: Patients received routine fasting and water restriction upon admission, with nasogastric tube placement for gastrointestinal decompression. Emergency open right hemicolectomy was performed. Both patient groups underwent endotracheal intubation under general anesthesia. The study group was positioned supine with legs spread apart. A CO₂ pneumoperitoneum was established at a pressure of 12 mmHg to 15 mmHg (1 mmHg = 0.133 kPa). A 10 mm trocar was inserted approximately 3 cm to 5 cm below the umbilicus as an observation port. A 12 mm trocar was placed 5 cm below the left costal margin on the midclavicular line. A 5 mm trocar was placed on the medial clavicular midline at the level of the left anterior superior iliac spine. Two 5 mm trocars were inserted at corresponding points on the right side. The surgeon positioned themselves on the patient's left side, the assistant on the right, and the scope operator between the patient's legs. The procedure employed a midline approach. The superior mesenteric vessels and their space were identified by their external appearance. The superior mesenteric vein (superior mesenteric vein, SMV).Expose the vasculature in the posterior peritoneum on the left surface of the SMV.Dissect and transect the right colic artery and vein close to the SMV trunk.Clear the perivascular lymphatic and adipose tissue.Continue dissecting cephalad to free the trunk of Henle and its branches.Transect the (accessory) right colic vein at its root.Then dissect the main trunks of the middle colic artery and vein,transecting their right branches.Then, extend the mesenteric space cephalad and to the right along the Toldt's space. Incise the middle portion of the gastrocolic ligament to enter the lesser omental sac. If a tumor is present in the hepatic flexure, clear the sixth lymph node group. Transect the hepatocolonic ligament laterally. Dissect the ascending colon and ileocecal region caudally along the hepatobiliary junction, connecting with the medial ileal retroperitoneal space. Dissect the terminal ileum for 10–20 cm. Upon completion of laparoscopic procedures, Deflate the pneumoperitoneum. Make a longitudinal midline incision in the upper abdomen, approximately 5 cm to 7 cm in length. Place an incision protector over the site. Perform tumor resection and ileocecal anastomosis externally. (See Figs. 1–4). For the control group, a 15–20 cm midline abdominal incision was made to enter the abdominal cavity. The surgical steps were identical to the intra-abdominal portion of the laparoscopic procedure. If significant intestinal dilatation was observed intraoperatively, distal ileal decompression was performed before proceeding with the remainder of the surgery. 1.3 Observation Indicators Compare the general characteristics of the two patient groups, as well as relevant surgical indicators including operative time, intraoperative blood loss, number of lymph nodes removed, time to first flatus, length of hospital stay, and early postoperative complications (anastomotic leakage, anastomotic bleeding, pulmonary and incisional infections, intestinal obstruction). 1.4 Statistical Methods All data were analyzed using SPSS 22.0 software. Quantitative data meeting the criteria of normal distribution and homogeneity of variance were expressed as mean ± standard deviation, with intergroup comparisons performed using t-tests. Qualitative data were presented as case numbers, with intergroup comparisons conducted using chi-square or Fisher's exact probability tests. P < 0.05 was considered statistically significant. 2 Results 2.1 Comparative analysis of baseline data Analysis of Surgical-Related Indicators Baseline characteristics between the two groups showed no statistically significant differences (P > 0.05), indicating comparability (Table 1). 2.2 Comparison of surgical observation indicators between two groups The study group exhibited significantly lower intraoperative blood loss (t = -7.673, P < 0.001) and faster postoperative anal gas passage time (t = -3.796, P < 0.001). The study group exhibited a statistically significant increase in operative time (t = 4.350, P 0.67) or length of hospital stay (t = 0.821, P > 0.41), as shown in Table 2. 2.3 Postoperative Complications: One case of intra-abdominal infection occurred in the study group, with a complication rate of 3.13% (1/32). In the control group, one case of intestinal obstruction, two cases of intra-abdominal infection, and four cases of incisional infection occurred, resulting in a complication rate of 29.16% (7/24). The difference between the two groups was statistically significant (P < 0.004). See Table 3. Discussion Colorectal cancer ranks as one of the most common malignant tumors of the digestive tract, occupying the third position in incidence among all malignancies [ 6 ] with a trend of increasing prevalence annually [ 7 – 8 ] . Early-stage colorectal cancer often presents without noticeable symptoms, making it prone to being overlooked. By the time patients seek medical attention, acute intestinal obstruction symptoms frequently manifest [ 9 ] , leading to proximal intestinal dilation, fluid accumulation, and gas retention—all of which complicate surgical procedures. Laparoscopic radical resection for colon cancer offers advantages including minimal trauma, reduced bleeding, rapid recovery, and shorter hospital stays. It adheres to the principle of tumor-free resection and yields mid- to long-term outcomes comparable to open surgery. Consequently, it is recommended as the standard procedure for colon cancer in domestic and international guidelines [ 10 – 11 ] . The presence of intestinal obstruction reduces intra-abdominal working space, impedes pneumoperitoneum establishment, and limits surgical maneuverability. This compromises intraoperative exploration, increases the risk of iatrogenic injury, and may necessitate conversion to open surgery or direct adoption of traditional open procedures. Such approaches carry higher trauma, increased intraoperative contamination risks, and slower postoperative recovery. Research indicates [ 12 ] : In cases of right-sided colon cancer with intestinal obstruction undergoing emergency laparoscopic surgery, after performing ileal decompression via a small upper abdominal incision during the procedure, the incision is sealed using an incision protector and rubber gloves to continue with laparoscopic right hemicolectomy. This approach improved operative space for laparoscopic procedures. However, intraoperative ileal decompression increased the risk of contaminating the surgical site, potentially leading to postoperative intra-abdominal infection and incisional infection. Additionally, some patients had a short ileal mesentery, complicating the decompression procedure.Huang Y et al. [ 13 ] demonstrated that patients with right-sided colon cancer obstruction who received self-expanding metal stents (SEMS) followed by elective surgery versus emergency surgery showed no significant differences in postoperative complications, mortality, or overall survival rates. Successful transnasal placement of an intestinal obstruction catheter effectively alleviates proximal intestinal dilatation caused by right-sided colon cancer. Research indicates [ 14 ] that X-ray-guided placement of an intestinal obstruction catheter can improve intestinal dilatation caused by ileocecal cancer. However, X-ray-guided procedures and prolonged catheterization expose both patients and physicians to extended periods of radiation. Lin Yanfeng, Li Bingrong et al. [ 15 – 16 ] reported: successful placement of biliary stents and metallic intestinal stents in the ileocecal region. Following resolution of intestinal obstruction, time-limited laparoscopic right hemicolectomy yielded favorable outcomes. Due to the right colon's distance from the anus—requiring passage through physiological bends in the splenic and hepatic regions—the procedure is time-consuming and labor-intensive. Other studies [ 17 ] also report that stent compression of tumors may increase the risk of metastasis, posing challenges to widespread adoption. Endoscopic-guided transnasal intestinal obstruction catheter placement is currently the most commonly used catheterization method. It allows for direct visualization during the procedure, saving time and effort while eliminating the risk of X-ray exposure. Simultaneous insertion and suctioning prevents aspiration of gastrointestinal contents by the patient, offering advantages over X-ray-guided intestinal obstruction catheter placement [ 18 – 19 ] . This study successfully placed intestinal obstruction tubes in 32 patients via gastroscopy. While performing gastrointestinal decompression, patients received fluid replacement, correction of anemia, and electrolyte imbalance. After relief of intestinal obstruction symptoms, enteral nutrition solutions were administered in appropriate amounts to improve patients' preoperative general condition, demonstrating advantages over parenteral nutrition. A study by van Barneveld KW et al [ 20 ] , compared the efficacy of early enteral nutrition versus early parenteral nutrition in high-risk patients with locally advanced or locally recurrent rectal cancer following surgery. Results indicated that early enteral nutrition reduced postoperative intestinal obstruction, anastomotic leakage, and hospital stay duration. By alleviating intestinal obstruction symptoms, it enabled conversion from emergency to elective surgery, thereby lowering surgical and anesthetic risks. This study demonstrated that although the study group had longer operative times than the control group, it showed significantly superior outcomes in terms of intraoperative blood loss, time to postoperative flatus, and postoperative complication rates, with statistically significant differences (P < 0.05). This suggests that preoperative transnasal intestinal obstruction catheter placement followed by scheduled laparoscopic right hemicolectomy can effectively reduce intraoperative bleeding, promote postoperative intestinal function recovery, and decrease postoperative complications. Regarding hospital stay, no statistically significant difference was observed between the two groups (P > 0.05). This discrepancy is likely attributable to the study group's longer preoperative preparation time compared to the control group, coupled with a shorter postoperative intestinal recovery period. Reports indicate [ 21 ] : After placement of an intestinal obstruction catheter, symptoms of intestinal obstruction resolved, but abdominal pain recurred. Abdominal CT revealed intussusception. Following catheter removal and surgical intervention, the patient subsequently died. Therefore, when abdominal pain and distension recur after intestinal obstruction catheter placement, intussusception should be considered, necessitating early detection and treatment. Another report indicates [ 22 ] : Following intestinal obstruction catheter placement, a patient developed intestinal torsion, potentially due to pre-existing small bowel tumors or adhesive intestinal obstruction. Thus, intestinal torsion and intussusception may occur with intestinal obstruction catheters, necessitating careful clinical monitoring.Under direct endoscopic visualization, the intestinal obstruction catheter is placed into the proximal jejunum. It is gradually advanced toward the site of intestinal obstruction as peristalsis progresses, a stepwise process that avoids the potential for rapid intestinal torsion associated with X-ray-guided catheter placement. Prior to catheter removal, thoroughly aspirate fluid from the tip balloon of the intestinal obstruction catheter. Administer oral liquid paraffin and inject an appropriate amount of liquid paraffin through the catheter drainage port [ 23 ] to maintain lubrication between the catheter and intestinal wall. Gradually and slowly withdraw the catheter while allowing the intestine's natural peristalsis to progress from proximal to distal segments, thereby reducing the risk of intussusception. Since the 21st century, robotic surgery has been increasingly applied in abdominal surgery. Compared with laparoscopic surgery, robotic surgery has incomparable advantages, such as high-definition 3D vision, tremor filtering, precise and flexible operation, and remote control. Especially in right-sided colon resection, it can reduce intraoperative blood loss, shorten hospital stay, and reduce the occurrence of complications, etc. [ 24 ] . Huscher CGS [ 25 ] and others used the surgical method of complete robot-assisted right-sided colon resection combined with intracorporeal robot suture anastomosis to complete the surgery for 123 patients. Standard univariate and multivariate methods were used for survival and recurrence analysis, which proved the safety and feasibility of intracorporeal robot suture anastomosis in complete robot-assisted right-sided colon resection. Recently, the Cornerstone Robotics team and the research team of the Chinese University of Hong Kong jointly published a research article [ 26 ] in the journal Science Robotics, exploring "the general task automation of the surgical instrument itself in laparoscopic robot-assisted surgery". This article points out that the intelligent surgical robot completed multiple surgical tasks in laparoscopic surgery on living animals, proving the feasibility of the intelligent surgical robot in real clinical scenarios, and bringing the autonomy of the surgical robot to a new height. At the same time, it also shows the safety paradigm of the human-machine collaboration mode, which is expected to greatly reduce the burden on doctors, improve surgical efficiency, and play a relatively large promoting role in training surgical doctors and other aspects. However, the robotic surgery system also requires sufficient abdominal cavity space to complete the surgical operation. Conclusion Preoperative transnasal intestinal obstruction catheter placement followed by timely laparoscopic radical resection of right-sided colon cancer effectively resolved the issue of insufficient abdominal space caused by proximal intestinal dilatation due to intestinal obstruction. The catheter placement procedure is simple, minimally invasive, associated with a low incidence of postoperative complications, and facilitates rapid recovery. It is safe and reliable, demonstrating significant clinical application value. However, this study involved a limited number of cases and was conducted at a single center, potentially introducing data bias. Long-term outcomes require further investigation in subsequent studies. Declarations Funding The authors declare that they have received financial support for the research, authorship, and/or publication of this article. This study was supported by the Xingtai City Key Research and Development Plan self-raised project (grant number 2025ZC191). Author Contribution JM and JZ drafted the main content of the manuscript, while NY and JL prepared Figures 1–4. All authors reviewed the manuscript. Acknowledgments The authors would like to express their sincere gratitude to the Xingtai Central Hospital of Hebei Province for their valuable contribution in providing the experimental conditions. References Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359(9325):2224–2229. McLeod R. Long-term results of laparoscopic-assisted colectomy are comparable to results after open colectomy. Ann Surg. 2008;248(1):8–9 Cao K, Wang Z, Han J. Hot Spotlight–On the Treatment of Obstructive Colorectal Cancer. Zhonghua Wei Chang Wai Ke Za Zhi. 2023;26(1): 44–50 Chinese Society of Laparoscopic and Endoscopic Surgery, Chinese Society of Colorectal Surgery, Chinese Association of Surgeons Colorectal Surgery Expert Working Group, et al. Guidelines for Laparoscopic Radical Resection of Colorectal Cancer (2023 Edition). Chinese Journal of Digestive Surgery, 2024, 23(01):10–22. DOI: 10.3760/cma.j.cn115610-20231229-00285 Chinese Society of Colorectal Surgery, Chinese Medical Association; Chinese Colorectal Clinical Research Collaborative Group. Chinese Expert Consensus on Surgery for Right Hemicolon Cancer (2024 Edition). Chinese Journal of Gastrointestinal Surgery, 2024, 27(09):879–890. DOI: 10.3760/cma.j.cn441530-20240817-00287 Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229–263 Sung H, Siegel RL, Laversanne M, et al. Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data. Lancet Oncol. 2025;26(1):51–63. doi: 10.1016/S1470-2045(24)00600-4 Yang M, Zhang J, Wang X. Interpretation of Colorectal Cancer Epidemiological Data Trends from 2013 to 2022 Released by the National Cancer Registry Center. Chinese Journal of Colorectal Diseases (Electronic Edition), 2024, 13(03):177–181. DOI: 10.3877/cma.j.issn.2095-3224.2024.03.001 Shimura T, Joh T. Evidence-based Clinical Management of Acute Malignant Colorectal Obstruction. J Clin Gastroenterol. 2016;50(4):273–85 National Health and Hygiene Commission of the People's Republic of China. Chinese Colorectal Cancer Diagnostic and Treatment Guidelines (2020 Edition). Zhonghua Wai Ke Za Zhi. 2020;58(8):561–585 Lauro A, Binetti M, Vaccari S, Cervellera M, Tonini V. Obstructing Left-Sided Colonic Cancer: Is Endoscopic Stenting a Bridge to Surgery or a Bridge to Nowhere? Dig Dis Sci. 2020;65(10):2789–2799 Lian Y, Song Z, Fan X, Hu Y, Fan X, Ma J, et al. Clinical observation on the treatment of right hemicolon cancer combined with acute intestinal obstruction by laparoscopic surgery after intestinal decompression. Zhonghua Jie Zhi Chang Ji Bing Dian Zi Za Zhi. 2024,13(2):129–134 Huang Y, Liao F, Zhan Z, Chen X, Chen H, Shu X. Efficacy and Safety Analysis of Emergency Endoscopic Self-Expanding Metal Stent Placement Without Fluoroscopic Assistance for Right-Sided Colonic Cancer Obstruction. Ann Surg Oncol. 2024;31(5):3212–3221 Guo Y, Du H, Li D. Transnasal-type intestinal obstruction catheter placement combined with laparoscopic treatment of malignant intestinal obstruction in the ileocecal region. Yi Xue Ying Xiang Xue Za Zhi. 2021;31(11):1922–1924 Lin Y, Zhang B, Wu W, et al. Surgical coordination of a case in which a biliary stent was placed at the end of the ileum to relieve malignant obstruction in the ileocecal region. Zhongguo Nei Jing Za Zhi. 2016;22(1):109–110 Liu B, Du Y, Chen J, et al. A case of colonoscopy-assisted placement of ileocolonic stent in the ileocecal region. Zhonghua Xiao Hua Nei Jing Za Zhi. 2006;23(3):178 Kim SJ, Kim HW, Park SB, et al. Colonic perforation either during or after stent insertion as a bridge to surgery for malignant colorectal obstruction increases the risk of peritoneal seeding. Surg Endosc. 2015;29(12):3499–3506 Li S. Clinical analysis of transgastroscopic placement of intestinal obstruction catheter for conservative treatment of intestinal obstruction. 7th Quan Guo Nei Jing Wai Ke Yan Tao Hui Lun Wen Ji. 2009:65–69 Qian J, Shi L, Shi D, et al. The value of a new nasogastroscopy-assisted method of indwelling transnasal-type intestinal obstruction catheters. Tian Jin Yi Yao. 2019,47(11):1179–1182 van Barneveld KW, Smeets BJ, Heesakkers FF, et al. Beneficial Effects of Early Enteral Nutrition After Major Rectal Surgery: A Possible Role for Conditionally Essential Amino Acids? Results of a Randomized Clinical Trial. Crit Care Med. 2016;44(6):e353-e361. doi: 10.1097/CCM.0000000000001640 Komagamine J, Noritomi D. Jejunal Intussusception Caused by a Nasointestinal Ileus Tube. Eur J Case Rep Intern Med. 2022;9(2):003161 Zhu L, Zheng YX, Chen KB. Clinical characteristics of nasointestinal ileus tube-induced intussusception: three case reports and a literature review. J Int Med Res. 2020;48(4):300060519878356. China Association of Medical Doctors Anorectal Physicians Branch, Hunan Society of Geriatrics Intestinal Obstruction Branch, Li X, et al. Expert consensus on the clinical use of intestinal obstruction catheters in the prevention and treatment of intestinal obstruction. Zhongguo Pu Tong Wai Ke Za Zhi. 2025,34(2):190–201 Chang WJ, Xu JM. Application and progress of Da Vinci robot radical resection for rectal cancer [J]. Chinese Journal of General Surgery: Basic and Clinical,2015,22(5):541–543. Huscher CGS, Lazzarin G, Marchegiani F, Marks J. Robotic right colectomy with robotic-sewn anastomosis: a pilot case series. J Robot Surg. 2023;17(2):427–434. Long Y, Lin A, Kwok DHC, Zhang L, Yang Z, Shi K, et al. Surgical embodied intelligence for generalized task autonomy in laparoscopic robot-assisted surgery. Sci Robot. 2025;10(104):eadt3093. Tables Tables 1 to 3 are available in the Supplementary Files section. Additional Declarations No competing interests reported. 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14:06:54","extension":"xml","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":61602,"visible":true,"origin":"","legend":"","description":"","filename":"a1c2fefbca77404480f5f705e3b6eb891structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7841921/v1/8aacb656a9e645135976a0b6.xml"},{"id":97261654,"identity":"a4216999-5246-41a4-a108-c49230a809b8","added_by":"auto","created_at":"2025-12-02 14:06:54","extension":"html","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":69038,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7841921/v1/d28a9e37dbd1c1eaa90c0715.html"},{"id":97261642,"identity":"1fb52e11-f2bc-4184-ba3f-c6d480b91f78","added_by":"auto","created_at":"2025-12-02 14:06:53","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":264572,"visible":true,"origin":"","legend":"\u003cp\u003eColon Cancer with Bowel Obstruction.\u003c/p\u003e","description":"","filename":"fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7841921/v1/5f38d7788eeadcbc4b019780.jpg"},{"id":97261645,"identity":"657e5871-758e-44f2-bd00-635e5838a06f","added_by":"auto","created_at":"2025-12-02 14:06:53","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":262312,"visible":true,"origin":"","legend":"\u003cp\u003eGastroscopic placement of intestinal obstruction catheter.\u003c/p\u003e","description":"","filename":"fig2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7841921/v1/223175d05cfc4e95ae126ede.jpg"},{"id":97261644,"identity":"8260eb07-8a81-4d08-9ef1-c7436875a473","added_by":"auto","created_at":"2025-12-02 14:06:53","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":281277,"visible":true,"origin":"","legend":"\u003cp\u003eIntestinal obstruction catheter tip passing through the descending portion of the duodenum\u003c/p\u003e","description":"","filename":"fig3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7841921/v1/bee45f44a866855b5067b9c0.jpg"},{"id":97367243,"identity":"68f8cd39-77e2-4e8d-8405-250e37cab743","added_by":"auto","created_at":"2025-12-03 16:17:42","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":229196,"visible":true,"origin":"","legend":"\u003cp\u003eAbdominal X-ray in standing position after bowel decompression\u003c/p\u003e","description":"","filename":"fig4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7841921/v1/4b065cf326dec830f4e818dc.jpg"},{"id":97372632,"identity":"da0f0977-c910-4fd8-9c7b-6942eb367290","added_by":"auto","created_at":"2025-12-03 16:32:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1520228,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7841921/v1/f85c53e6-cad5-4835-9b7e-c9e96bc6b03c.pdf"},{"id":97261646,"identity":"860b6fdf-f59b-4b47-bdbe-dc80fc7ccf96","added_by":"auto","created_at":"2025-12-02 14:06:54","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":55441,"visible":true,"origin":"","legend":"","description":"","filename":"tables.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7841921/v1/2da6f9217db7d840de21672c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Efficacy of Transnasal Intestinal Obstruction Catheters in Patients with Right colon Cancer and Acute Intestinal Obstruction","fulltext":[{"header":"Introduction","content":"\u003cp\u003eLaparoscopic radical resection for colorectal cancer offers advantages such as minimally invasive procedures, reduced postoperative pain, faster recovery of bowel function, and shorter hospital stays. Studies have demonstrated that laparoscopic surgery yields comparable or superior outcomes to open surgery \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. However, some patients with advanced colon cancer present with acute intestinal obstruction \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e, precluding routine preoperative preparation and necessitating emergency surgery. Due to intestinal dilation reducing operative space within the abdomen, laparoscopic procedures often prove unfeasible, requiring conversion to traditional open surgery. This approach involves greater surgical trauma and slower recovery. Furthermore, the larger incision increases susceptibility to wound infection and delayed healing, potentially compromising subsequent comprehensive treatment.Since 2020, the Gastrointestinal Surgery Department of Xingtai Central Hospital has performed laparoscopic-assisted right hemicolectomy with intestinal decompression via nasojejunal tube placement at the terminal ileum or ascending colon in 32 patients with right hemicolonic cancer complicated by acute intestinal obstruction. followed by laparoscopic-assisted right hemicolectomy. Compared with 24 concurrent cases undergoing conventional open right hemicolectomy for colon cancer, this approach was clinically feasible with satisfactory outcomes. Specific surgical procedures adhered to relevant guidelines and protocols \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. The findings are reported below.\u003c/p\u003e"},{"header":"1 Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e1.1 General Information\u003c/h2\u003e\u003cp\u003eClinical data were collected from 56 patients with right-sided colon cancer complicated by acute intestinal obstruction admitted to the Department of Gastrointestinal Surgery, Xingtai Central Hospital, Hebei Province, between January 2020 and December 2024. Inclusion Criteria: (1) Preoperative abdominal contrast-enhanced CT clearly demonstrated the lesion location in the ileocecal region to the hepatic flexure of the colon, accompanied by complete intestinal obstruction; (2) No distant organ metastasis; (3) Postoperative pathological staging of the tumor was Stage II to III; (4) Postoperative pathology confirmed colon adenocarcinoma; (5) No contraindications for laparoscopic surgery. Exclusion criteria: (1) History of prior abdominal surgery or significant intraoperative abdominal adhesions; (2) Distant tumor metastasis; (3) Preoperative evidence of tumor perforation, peritonitis, or unresectable tumor; (4) Severe cardiopulmonary or renal dysfunction; (5) Advanced age or inability to tolerate endoscopic procedures.A total of 23 males and 33 females aged 42 to 75 years were included. Tumors were located in the hepatic flexure of the colon in 22 cases, the ascending colon in 15 cases, and the ileocecal region in 19 cases. Patients were divided into two groups: the study group (n\u0026thinsp;=\u0026thinsp;32) underwent laparoscopic surgery after transnasal intestinal obstruction catheter placement, while the control group (n\u0026thinsp;=\u0026thinsp;24) received emergency traditional open surgery upon admission. The study protocol was approved by the Medical Ethics Committee of Xingtai Central Hospital, and all patients signed informed consent forms.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e1.2 Surgical Procedures\u003c/h2\u003e\u003cp\u003eBoth groups received supportive treatment upon admission, including fasting with water, parenteral nutrition, anti-infective therapy, fluid replacement, correction of anemia, and correction of electrolyte imbalances. A cleansing enema was administered preoperatively, and all patients underwent radical resection. The study group underwent endoscopic placement of a nasojejunal obstruction catheter into the duodenum or upper jejunum under direct endoscopic visualization (Fig.\u0026nbsp;2). Utilizing the self-gravity of the catheter's tip balloon, the nasojejunal obstruction catheter advanced distally into the small intestine with gastrointestinal peristalsis, positioning it as close as possible to the obstruction site. After 24 hours, gastrointestinal contrast studies confirmed placement of the nasojejunal tube in the terminal ileum or ascending colon, enabling continuous suction decompression of the small intestine and right colon. Once abdominal pain and distension resolved, patients underwent scheduled laparoscopic right hemicolectomy. Control group: Patients received routine fasting and water restriction upon admission, with nasogastric tube placement for gastrointestinal decompression. Emergency open right hemicolectomy was performed.\u003c/p\u003e\u003cp\u003eBoth patient groups underwent endotracheal intubation under general anesthesia. The study group was positioned supine with legs spread apart. A CO₂ pneumoperitoneum was established at a pressure of 12 mmHg to 15 mmHg (1 mmHg\u0026thinsp;=\u0026thinsp;0.133 kPa). A 10 mm trocar was inserted approximately 3 cm to 5 cm below the umbilicus as an observation port. A 12 mm trocar was placed 5 cm below the left costal margin on the midclavicular line. A 5 mm trocar was placed on the medial clavicular midline at the level of the left anterior superior iliac spine. Two 5 mm trocars were inserted at corresponding points on the right side. The surgeon positioned themselves on the patient's left side, the assistant on the right, and the scope operator between the patient's legs. The procedure employed a midline approach. The superior mesenteric vessels and their space were identified by their external appearance. The superior mesenteric vein (superior mesenteric vein, SMV).Expose the vasculature in the posterior peritoneum on the left surface of the SMV.Dissect and transect the right colic artery and vein close to the SMV trunk.Clear the perivascular lymphatic and adipose tissue.Continue dissecting cephalad to free the trunk of Henle and its branches.Transect the (accessory) right colic vein at its root.Then dissect the main trunks of the middle colic artery and vein,transecting their right branches.Then, extend the mesenteric space cephalad and to the right along the Toldt's space. Incise the middle portion of the gastrocolic ligament to enter the lesser omental sac. If a tumor is present in the hepatic flexure, clear the sixth lymph node group. Transect the hepatocolonic ligament laterally. Dissect the ascending colon and ileocecal region caudally along the hepatobiliary junction, connecting with the medial ileal retroperitoneal space. Dissect the terminal ileum for 10\u0026ndash;20 cm. Upon completion of laparoscopic procedures, Deflate the pneumoperitoneum. Make a longitudinal midline incision in the upper abdomen, approximately 5 cm to 7 cm in length. Place an incision protector over the site. Perform tumor resection and ileocecal anastomosis externally. (See Figs.\u0026nbsp;1\u0026ndash;4). For the control group, a 15\u0026ndash;20 cm midline abdominal incision was made to enter the abdominal cavity. The surgical steps were identical to the intra-abdominal portion of the laparoscopic procedure. If significant intestinal dilatation was observed intraoperatively, distal ileal decompression was performed before proceeding with the remainder of the surgery.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e1.3 Observation Indicators\u003c/h2\u003e\u003cp\u003eCompare the general characteristics of the two patient groups, as well as relevant surgical indicators including operative time, intraoperative blood loss, number of lymph nodes removed, time to first flatus, length of hospital stay, and early postoperative complications (anastomotic leakage, anastomotic bleeding, pulmonary and incisional infections, intestinal obstruction).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e1.4 Statistical Methods\u003c/h2\u003e\u003cp\u003eAll data were analyzed using SPSS 22.0 software. Quantitative data meeting the criteria of normal distribution and homogeneity of variance were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, with intergroup comparisons performed using t-tests. Qualitative data were presented as case numbers, with intergroup comparisons conducted using chi-square or Fisher's exact probability tests. P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"2 Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Comparative analysis of baseline data\u003c/h2\u003e\u003cp\u003eAnalysis of Surgical-Related Indicators Baseline characteristics between the two groups showed no statistically significant differences (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), indicating comparability (Table\u0026nbsp;1).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e\u003cb\u003e2.2 Comparison of surgical observation indicators between two groups\u003c/b\u003e\u003c/h2\u003e\u003cp\u003eThe study group exhibited significantly lower intraoperative blood loss (t = -7.673, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and faster postoperative anal gas passage time (t = -3.796, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The study group exhibited a statistically significant increase in operative time (t\u0026thinsp;=\u0026thinsp;4.350, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). No statistically significant differences were observed between groups in the number of lymph nodes removed (t\u0026thinsp;=\u0026thinsp;0.423, P\u0026thinsp;\u0026gt;\u0026thinsp;0.67) or length of hospital stay (t\u0026thinsp;=\u0026thinsp;0.821, P\u0026thinsp;\u0026gt;\u0026thinsp;0.41), as shown in Table\u0026nbsp;2.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Postoperative Complications:\u003c/h2\u003e\u003cp\u003eOne case of intra-abdominal infection occurred in the study group, with a complication rate of 3.13% (1/32). In the control group, one case of intestinal obstruction, two cases of intra-abdominal infection, and four cases of incisional infection occurred, resulting in a complication rate of 29.16% (7/24). The difference between the two groups was statistically significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.004). See Table\u0026nbsp;3.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eColorectal cancer ranks as one of the most common malignant tumors of the digestive tract, occupying the third position in incidence among all malignancies \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e with a trend of increasing prevalence annually\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. Early-stage colorectal cancer often presents without noticeable symptoms, making it prone to being overlooked. By the time patients seek medical attention, acute intestinal obstruction symptoms frequently manifest \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e, leading to proximal intestinal dilation, fluid accumulation, and gas retention\u0026mdash;all of which complicate surgical procedures. Laparoscopic radical resection for colon cancer offers advantages including minimal trauma, reduced bleeding, rapid recovery, and shorter hospital stays. It adheres to the principle of tumor-free resection and yields mid- to long-term outcomes comparable to open surgery. Consequently, it is recommended as the standard procedure for colon cancer in domestic and international guidelines \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. The presence of intestinal obstruction reduces intra-abdominal working space, impedes pneumoperitoneum establishment, and limits surgical maneuverability. This compromises intraoperative exploration, increases the risk of iatrogenic injury, and may necessitate conversion to open surgery or direct adoption of traditional open procedures. Such approaches carry higher trauma, increased intraoperative contamination risks, and slower postoperative recovery.\u003c/p\u003e\u003cp\u003eResearch indicates \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e: In cases of right-sided colon cancer with intestinal obstruction undergoing emergency laparoscopic surgery, after performing ileal decompression via a small upper abdominal incision during the procedure, the incision is sealed using an incision protector and rubber gloves to continue with laparoscopic right hemicolectomy. This approach improved operative space for laparoscopic procedures. However, intraoperative ileal decompression increased the risk of contaminating the surgical site, potentially leading to postoperative intra-abdominal infection and incisional infection. Additionally, some patients had a short ileal mesentery, complicating the decompression procedure.Huang Y et al. \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e demonstrated that patients with right-sided colon cancer obstruction who received self-expanding metal stents (SEMS) followed by elective surgery versus emergency surgery showed no significant differences in postoperative complications, mortality, or overall survival rates. Successful transnasal placement of an intestinal obstruction catheter effectively alleviates proximal intestinal dilatation caused by right-sided colon cancer. Research indicates \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e that X-ray-guided placement of an intestinal obstruction catheter can improve intestinal dilatation caused by ileocecal cancer. However, X-ray-guided procedures and prolonged catheterization expose both patients and physicians to extended periods of radiation. Lin Yanfeng, Li Bingrong et al. \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e reported: successful placement of biliary stents and metallic intestinal stents in the ileocecal region. Following resolution of intestinal obstruction, time-limited laparoscopic right hemicolectomy yielded favorable outcomes. Due to the right colon's distance from the anus\u0026mdash;requiring passage through physiological bends in the splenic and hepatic regions\u0026mdash;the procedure is time-consuming and labor-intensive. Other studies \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e also report that stent compression of tumors may increase the risk of metastasis, posing challenges to widespread adoption.\u003c/p\u003e\u003cp\u003eEndoscopic-guided transnasal intestinal obstruction catheter placement is currently the most commonly used catheterization method. It allows for direct visualization during the procedure, saving time and effort while eliminating the risk of X-ray exposure. Simultaneous insertion and suctioning prevents aspiration of gastrointestinal contents by the patient, offering advantages over X-ray-guided intestinal obstruction catheter placement \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. This study successfully placed intestinal obstruction tubes in 32 patients via gastroscopy. While performing gastrointestinal decompression, patients received fluid replacement, correction of anemia, and electrolyte imbalance. After relief of intestinal obstruction symptoms, enteral nutrition solutions were administered in appropriate amounts to improve patients' preoperative general condition, demonstrating advantages over parenteral nutrition. A study by van Barneveld KW et al\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e, compared the efficacy of early enteral nutrition versus early parenteral nutrition in high-risk patients with locally advanced or locally recurrent rectal cancer following surgery. Results indicated that early enteral nutrition reduced postoperative intestinal obstruction, anastomotic leakage, and hospital stay duration. By alleviating intestinal obstruction symptoms, it enabled conversion from emergency to elective surgery, thereby lowering surgical and anesthetic risks. This study demonstrated that although the study group had longer operative times than the control group, it showed significantly superior outcomes in terms of intraoperative blood loss, time to postoperative flatus, and postoperative complication rates, with statistically significant differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). This suggests that preoperative transnasal intestinal obstruction catheter placement followed by scheduled laparoscopic right hemicolectomy can effectively reduce intraoperative bleeding, promote postoperative intestinal function recovery, and decrease postoperative complications. Regarding hospital stay, no statistically significant difference was observed between the two groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). This discrepancy is likely attributable to the study group's longer preoperative preparation time compared to the control group, coupled with a shorter postoperative intestinal recovery period.\u003c/p\u003e\u003cp\u003eReports indicate\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e: After placement of an intestinal obstruction catheter, symptoms of intestinal obstruction resolved, but abdominal pain recurred. Abdominal CT revealed intussusception. Following catheter removal and surgical intervention, the patient subsequently died. Therefore, when abdominal pain and distension recur after intestinal obstruction catheter placement, intussusception should be considered, necessitating early detection and treatment. Another report indicates \u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e: Following intestinal obstruction catheter placement, a patient developed intestinal torsion, potentially due to pre-existing small bowel tumors or adhesive intestinal obstruction. Thus, intestinal torsion and intussusception may occur with intestinal obstruction catheters, necessitating careful clinical monitoring.Under direct endoscopic visualization, the intestinal obstruction catheter is placed into the proximal jejunum. It is gradually advanced toward the site of intestinal obstruction as peristalsis progresses, a stepwise process that avoids the potential for rapid intestinal torsion associated with X-ray-guided catheter placement. Prior to catheter removal, thoroughly aspirate fluid from the tip balloon of the intestinal obstruction catheter. Administer oral liquid paraffin and inject an appropriate amount of liquid paraffin through the catheter drainage port \u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e to maintain lubrication between the catheter and intestinal wall. Gradually and slowly withdraw the catheter while allowing the intestine's natural peristalsis to progress from proximal to distal segments, thereby reducing the risk of intussusception.\u003c/p\u003e\u003cp\u003eSince the 21st century, robotic surgery has been increasingly applied in abdominal surgery. Compared with laparoscopic surgery, robotic surgery has incomparable advantages, such as high-definition 3D vision, tremor filtering, precise and flexible operation, and remote control. Especially in right-sided colon resection, it can reduce intraoperative blood loss, shorten hospital stay, and reduce the occurrence of complications, etc.\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. Huscher CGS\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e and others used the surgical method of complete robot-assisted right-sided colon resection combined with intracorporeal robot suture anastomosis to complete the surgery for 123 patients. Standard univariate and multivariate methods were used for survival and recurrence analysis, which proved the safety and feasibility of intracorporeal robot suture anastomosis in complete robot-assisted right-sided colon resection. Recently, the Cornerstone Robotics team and the research team of the Chinese University of Hong Kong jointly published a research article\u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e in the journal Science Robotics, exploring \"the general task automation of the surgical instrument itself in laparoscopic robot-assisted surgery\". This article points out that the intelligent surgical robot completed multiple surgical tasks in laparoscopic surgery on living animals, proving the feasibility of the intelligent surgical robot in real clinical scenarios, and bringing the autonomy of the surgical robot to a new height. At the same time, it also shows the safety paradigm of the human-machine collaboration mode, which is expected to greatly reduce the burden on doctors, improve surgical efficiency, and play a relatively large promoting role in training surgical doctors and other aspects. However, the robotic surgery system also requires sufficient abdominal cavity space to complete the surgical operation.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePreoperative transnasal intestinal obstruction catheter placement followed by timely laparoscopic radical resection of right-sided colon cancer effectively resolved the issue of insufficient abdominal space caused by proximal intestinal dilatation due to intestinal obstruction. The catheter placement procedure is simple, minimally invasive, associated with a low incidence of postoperative complications, and facilitates rapid recovery. It is safe and reliable, demonstrating significant clinical application value. However, this study involved a limited number of cases and was conducted at a single center, potentially introducing data bias. Long-term outcomes require further investigation in subsequent studies.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have received financial support for the research, authorship, and/or publication of this article. This study was supported by the Xingtai City Key Research and Development Plan self-raised project (grant number 2025ZC191).\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJM and JZ drafted the main content of the manuscript, while NY and JL prepared Figures 1\u0026ndash;4. All authors reviewed the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgments\u003c/h2\u003e\u003cp\u003eThe authors would like to express their sincere gratitude to the Xingtai Central Hospital of Hebei Province for their valuable contribution in providing the experimental conditions.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLacy AM, Garc\u0026iacute;a-Valdecasas JC, Delgado S, Castells A, Taur\u0026aacute; P, Piqu\u0026eacute; JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359(9325):2224\u0026ndash;2229.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMcLeod R. Long-term results of laparoscopic-assisted colectomy are comparable to results after open colectomy. Ann Surg. 2008;248(1):8\u0026ndash;9\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCao K, Wang Z, Han J. Hot Spotlight\u0026ndash;On the Treatment of Obstructive Colorectal Cancer. Zhonghua Wei Chang Wai Ke Za Zhi. 2023;26(1): 44\u0026ndash;50\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChinese Society of Laparoscopic and Endoscopic Surgery, Chinese Society of Colorectal Surgery, Chinese Association of Surgeons Colorectal Surgery Expert Working Group, et al. Guidelines for Laparoscopic Radical Resection of Colorectal Cancer (2023 Edition). Chinese Journal of Digestive Surgery, 2024, 23(01):10\u0026ndash;22. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3760/cma.j.cn115610-20231229-00285\u003c/span\u003e\u003cspan address=\"10.3760/cma.j.cn115610-20231229-00285\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChinese Society of Colorectal Surgery, Chinese Medical Association; Chinese Colorectal Clinical Research Collaborative Group. Chinese Expert Consensus on Surgery for Right Hemicolon Cancer (2024 Edition). Chinese Journal of Gastrointestinal Surgery, 2024, 27(09):879\u0026ndash;890. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3760/cma.j.cn441530-20240817-00287\u003c/span\u003e\u003cspan address=\"10.3760/cma.j.cn441530-20240817-00287\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229\u0026ndash;263\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSung H, Siegel RL, Laversanne M, et al. Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data. Lancet Oncol. 2025;26(1):51\u0026ndash;63. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/S1470-2045(24)00600-4\u003c/span\u003e\u003cspan address=\"10.1016/S1470-2045(24)00600-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYang M, Zhang J, Wang X. Interpretation of Colorectal Cancer Epidemiological Data Trends from 2013 to 2022 Released by the National Cancer Registry Center. Chinese Journal of Colorectal Diseases (Electronic Edition), 2024, 13(03):177\u0026ndash;181. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3877/cma.j.issn.2095-3224.2024.03.001\u003c/span\u003e\u003cspan address=\"10.3877/cma.j.issn.2095-3224.2024.03.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShimura T, Joh T. Evidence-based Clinical Management of Acute Malignant Colorectal Obstruction. J Clin Gastroenterol. 2016;50(4):273\u0026ndash;85\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNational Health and Hygiene Commission of the People's Republic of China. Chinese Colorectal Cancer Diagnostic and Treatment Guidelines (2020 Edition). Zhonghua Wai Ke Za Zhi. 2020;58(8):561\u0026ndash;585\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLauro A, Binetti M, Vaccari S, Cervellera M, Tonini V. Obstructing Left-Sided Colonic Cancer: Is Endoscopic Stenting a Bridge to Surgery or a Bridge to Nowhere? Dig Dis Sci. 2020;65(10):2789\u0026ndash;2799\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLian Y, Song Z, Fan X, Hu Y, Fan X, Ma J, et al. Clinical observation on the treatment of right hemicolon cancer combined with acute intestinal obstruction by laparoscopic surgery after intestinal decompression. Zhonghua Jie Zhi Chang Ji Bing Dian Zi Za Zhi. 2024,13(2):129\u0026ndash;134\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHuang Y, Liao F, Zhan Z, Chen X, Chen H, Shu X. Efficacy and Safety Analysis of Emergency Endoscopic Self-Expanding Metal Stent Placement Without Fluoroscopic Assistance for Right-Sided Colonic Cancer Obstruction. Ann Surg Oncol. 2024;31(5):3212\u0026ndash;3221\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGuo Y, Du H, Li D. Transnasal-type intestinal obstruction catheter placement combined with laparoscopic treatment of malignant intestinal obstruction in the ileocecal region. Yi Xue Ying Xiang Xue Za Zhi. 2021;31(11):1922\u0026ndash;1924\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLin Y, Zhang B, Wu W, et al. Surgical coordination of a case in which a biliary stent was placed at the end of the ileum to relieve malignant obstruction in the ileocecal region. Zhongguo Nei Jing Za Zhi. 2016;22(1):109\u0026ndash;110\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiu B, Du Y, Chen J, et al. A case of colonoscopy-assisted placement of ileocolonic stent in the ileocecal region. Zhonghua Xiao Hua Nei Jing Za Zhi. 2006;23(3):178\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKim SJ, Kim HW, Park SB, et al. Colonic perforation either during or after stent insertion as a bridge to surgery for malignant colorectal obstruction increases the risk of peritoneal seeding. Surg Endosc. 2015;29(12):3499\u0026ndash;3506\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLi S. Clinical analysis of transgastroscopic placement of intestinal obstruction catheter for conservative treatment of intestinal obstruction. 7th Quan Guo Nei Jing Wai Ke Yan Tao Hui Lun Wen Ji. 2009:65\u0026ndash;69\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eQian J, Shi L, Shi D, et al. The value of a new nasogastroscopy-assisted method of indwelling transnasal-type intestinal obstruction catheters. Tian Jin Yi Yao. 2019,47(11):1179\u0026ndash;1182\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003evan Barneveld KW, Smeets BJ, Heesakkers FF, et al. Beneficial Effects of Early Enteral Nutrition After Major Rectal Surgery: A Possible Role for Conditionally Essential Amino Acids? Results of a Randomized Clinical Trial. Crit Care Med. 2016;44(6):e353-e361. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/CCM.0000000000001640\u003c/span\u003e\u003cspan address=\"10.1097/CCM.0000000000001640\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKomagamine J, Noritomi D. Jejunal Intussusception Caused by a Nasointestinal Ileus Tube. Eur J Case Rep Intern Med. 2022;9(2):003161\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhu L, Zheng YX, Chen KB. Clinical characteristics of nasointestinal ileus tube-induced intussusception: three case reports and a literature review. J Int Med Res. 2020;48(4):300060519878356.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChina Association of Medical Doctors Anorectal Physicians Branch, Hunan Society of Geriatrics Intestinal Obstruction Branch, Li X, et al. Expert consensus on the clinical use of intestinal obstruction catheters in the prevention and treatment of intestinal obstruction. Zhongguo Pu Tong Wai Ke Za Zhi. 2025,34(2):190\u0026ndash;201\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChang WJ, Xu JM. Application and progress of Da Vinci robot radical resection for rectal cancer [J]. Chinese Journal of General Surgery: Basic and Clinical,2015,22(5):541\u0026ndash;543.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHuscher CGS, Lazzarin G, Marchegiani F, Marks J. Robotic right colectomy with robotic-sewn anastomosis: a pilot case series. J Robot Surg. 2023;17(2):427\u0026ndash;434.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLong Y, Lin A, Kwok DHC, Zhang L, Yang Z, Shi K, et al. Surgical embodied intelligence for generalized task autonomy in laparoscopic robot-assisted surgery. Sci Robot. 2025;10(104):eadt3093.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 3 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Clinical Efficacy, Intestinal obstruction, Preoperative decompression, Right hemicolon cancer, Transnasal Intestinal Obstruction Catheters, Laparoscopic right hemicolectomy","lastPublishedDoi":"10.21203/rs.3.rs-7841921/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7841921/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo evaluate the efficacy of laparoscopic right hemicolectomy following nasojejunal decompression in patients with right hemicolonic cancer complicated by intestinal obstruction.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA retrospective analysis was conducted on 56 patients with right hemicolonic cancer and acute intestinal obstruction admitted to our hospital. Thirty-two patients underwent laparoscopic-assisted right hemicolectomy after nasojejunal tube decompression (study group), while 24 patients underwent conventional open right hemicolectomy (control group). The two groups were compared in terms of operative time variation, intraoperative blood loss, number of lymph nodes dissected, time to first flatus, length of hospital stay, and postoperative complications.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe baseline characteristics of patients in both the study group and control group were comparable. Compared with the control group, the study group exhibited lower intraoperative blood loss (t=-7.673, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), faster postoperative anal gas passage time (t=-3.796, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and longer operative duration (t\u0026thinsp;=\u0026thinsp;4.350, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). There were no statistically significant differences between the study and control groups in terms of the number of lymph nodes removed (t\u0026thinsp;=\u0026thinsp;0.423, P\u0026thinsp;\u0026gt;\u0026thinsp;0.67) or length of hospital stay (t\u0026thinsp;=\u0026thinsp;0.821, P\u0026thinsp;\u0026gt;\u0026thinsp;0.41). The incidence of early postoperative complications was 3.13% and 29.16%, respectively, with no statistically significant difference (P\u0026thinsp;\u0026lt;\u0026thinsp;0.004).Conclusion: For patients with right-sided colon cancer complicated by acute intestinal obstruction, performing laparoscopic-assisted right hemicolectomy with primary intestinal anastomosis within a limited timeframe following nasojejunal tube placement for intestinal decompression effectively addresses the issue of limited operative space during laparoscopy. This approach demonstrates clinical value in reducing intraoperative bleeding, promoting postoperative gastrointestinal function, and decreasing postoperative complications.\u003c/p\u003e","manuscriptTitle":"Clinical Efficacy of Transnasal Intestinal Obstruction Catheters in Patients with Right colon Cancer and Acute Intestinal Obstruction","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-02 14:06:49","doi":"10.21203/rs.3.rs-7841921/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-15T09:23:06+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-25T07:52:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-22T16:40:21+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-15T12:35:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-09T14:12:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"119468900574555721056330209918570881121","date":"2025-12-09T14:06:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"135007160806628940053290849159393430097","date":"2025-12-08T14:01:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-07T17:43:46+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-06T19:06:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"239365286410902944319676694300941232997","date":"2025-12-06T16:16:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"329188278733790293051442819509070205436","date":"2025-12-06T14:44:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-05T23:24:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"211104470398181941995774972914449728239","date":"2025-12-05T07:50:40+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-05T01:42:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"125616676781010094165886699758673557029","date":"2025-12-05T01:14:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"287068462966408722144007768355756571124","date":"2025-12-04T18:55:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"296770076617924621743981078088359516446","date":"2025-11-30T12:45:30+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-26T12:39:03+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-21T17:39:30+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-21T17:37:53+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Medical Research","date":"2025-10-12T16:08:22+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b0560cc8-a051-496c-b620-fc25faec1c48","owner":[],"postedDate":"December 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-14T01:23:58+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-02 14:06:49","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7841921","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7841921","identity":"rs-7841921","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}