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腹腔镜体内直肠横断术双吻合器技术吻合的安全性

Safety of laparoscopic intracorporeal rectal transection with double-stapling technique anastomosis.

作者信息

Yamamoto Seiichiro, Fujita Shin, Akasu Takayuki, Moriya Yoshihiro

机构信息

Division of Colorectal Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.

出版信息

Surg Laparosc Endosc Percutan Tech. 2005 Apr;15(2):70-4. doi: 10.1097/01.sle.0000160295.08783.b3.

Abstract

To assess the feasibility and analyze the short-term outcomes of laparoscopic intracorporeal rectal transection with double-stapling technique anastomosis, a review was performed of a prospective registry of 67 patients who underwent laparoscopic sigmoidectomy and anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis between July 2001 and January 2004. Patients were divided into 3 groups: sigmoid colon/rectosigmoid carcinoma, upper rectal carcinoma, and middle/lower rectal carcinoma. A comparison was made of the short-term outcomes among the groups. The number of cartridges required in bowel transection was significantly increased in patients with middle/lower rectal carcinoma, and significant differences were observed in the length of the first stapler cartridge fired for rectal transection. Furthermore, mean operative time and blood loss were also significantly greater in the middle/lower rectum group; however, complication rates and postoperative course were similar among the 3 groups. No anastomotic leakage was observed. Laparoscopic intracorporeal rectal transection with double-stapling technique anastomosis can be performed safely without increased morbidity or mortality.

摘要

为评估腹腔镜体内直肠横断术联合双吻合器技术吻合的可行性并分析其短期疗效,我们回顾了2001年7月至2004年1月期间67例行腹腔镜乙状结肠切除术及前路切除术并采用体内直肠横断术联合双吻合器技术吻合的患者的前瞻性登记资料。患者分为3组:乙状结肠/直肠乙状结肠交界处癌、上段直肠癌和中/下段直肠癌。对各组的短期疗效进行了比较。中/下段直肠癌患者在肠道横断时所需的钉仓数量显著增加,且在直肠横断时首次使用的钉仓长度方面观察到显著差异。此外,中/下段直肠组的平均手术时间和失血量也显著更多;然而,3组之间的并发症发生率和术后病程相似。未观察到吻合口漏。腹腔镜体内直肠横断术联合双吻合器技术吻合可安全进行,且发病率和死亡率不会增加。

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