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结肠癌右半结肠切除术后的回结肠吻合术:功能性端端吻合还是端侧吻合?

Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side?

作者信息

Liu Zheng, Wang Guiyu, Yang Ming, Chen Yinggang, Miao Dazhuang, Muhammad Shan, Wang Xishan

机构信息

Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, 150081 Harbin, China.

出版信息

World J Surg Oncol. 2014 Oct 7;12:306. doi: 10.1186/1477-7819-12-306.

Abstract

BACKGROUND

The purpose of this study was to compare short-term clinical outcomes of ileocolonic functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) following resection of the right colon for cancer.

METHODS

We enrolled 379 patients who underwent ileocolonic anastomosis following resection of the right colon for cancer by a single surgeon, from January 2009 through June 2012. Patient characteristics, operative results, and postoperative complications were analyzed.

RESULTS

A total of 164 patients received ESA and 215 patients received FEEA. The FEEA group had a lower incidence of anastomotic error (0.9% versus 4.3%; P = 0.04) and a shorter operating time (140.4 ± 14.9 min versus 150.5 ± 20.1 min; P = 0.001). The length of hospital stay (10.9 ± 3.5 days versus 11.3 ± 4.0 days; P = 0.36) and anastomotic leakage (1.8% versus 0.5%; P = 0.20) were similar in both groups. No relevant differences between FEEA and ESA were observed for blood loss, retrieved lymph nodes, first flatus and postoperative complications.

CONCLUSION

An FEEA after right hemicolectomy for colon cancer is a safe and reliable anastomotic technique, resulting in a favorable outcome in selected patients with the right colon cancer.

摘要

背景

本研究旨在比较结肠癌右半结肠切除术后回结肠功能性端端吻合术(FEEA)和端侧吻合术(ESA)的短期临床疗效。

方法

我们纳入了2009年1月至2012年6月期间由同一外科医生进行结肠癌右半结肠切除术后回结肠吻合术的379例患者。分析了患者特征、手术结果和术后并发症。

结果

共有164例患者接受了ESA,215例患者接受了FEEA。FEEA组吻合口失误发生率较低(0.9%对4.3%;P = 0.04),手术时间较短(140.4 ± 14.9分钟对150.5 ± 20.1分钟;P = 0.001)。两组的住院时间(10.9 ± 3.5天对11.3 ± 4.0天;P = 0.36)和吻合口漏发生率(1.8%对0.5%;P = 0.20)相似。FEEA和ESA在失血、回收淋巴结、首次排气和术后并发症方面未观察到相关差异。

结论

结肠癌右半结肠切除术后的FEEA是一种安全可靠的吻合技术,在部分结肠癌患者中可取得良好疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8eb8/4198793/29e760877046/12957_2013_1777_Fig1_HTML.jpg

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