Sun Xiyu, Qiu Huizhong, Fei Kailun, Xu Lai, Lu Junyang, Zhang Guannan, Xiao Yi
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Aug 25;20(8):891-895.
To compare the difference of intra-abdominal infection between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in patients undergoing laparoscopic right hemicolectomy within postoperative 30 days.
Clinical date of right colon cancer patients undergoing laparoscopic right hemicolectomy at the Department of Colorectal Surgery, PUMCH from January 1st, 2013 to October 31st, 2016 were retrospectively analyzed. Patients with stage IV cancers which could not be radically resected, emergency operation and conversion to open surgery were excluded. The intracorporeal anastomosis and extracorporeal anastomosis were compared in the items of operation time, postoperative infection and postoperative hospital stay.
A total of 194 patients were enrolled in the study, including 73 patients with IA and 121 patients with EA. No significant differences were found in gender, age, previous operation history, tumor site and T stage of the tumor between two groups (all P>0.05). There were also no significant differences in mean operative time (162.4 minutes vs. 167.7 minutes, P=0.257), time to first flatus (3.3 days vs. 3.4 days, P=0.744), number of harvested lymph nodes (30.3 nodes vs. 33.8 nodes, P=0.071) and postoperative hospital stay (7 days vs. 7 days, P=0.067) between two groups. The incidence of intra-abdominal infection in patients with IA was significantly higher than that in those with EA [13.7%(10/73) vs. 1.7%(2/121), P=0.001], while the differences of the incidence of wound infection [1.4%(1/73) vs. 3.3%(4/121), P=0.652], respiratory infection [1.4%(1/73) vs. 3.3%(4/121), P=0.652] and urinary tract infection [2.7%(2/73) vs. 0.8%(1/121), P=0.558] were not significant.
Compared with EA, IA may increase the risk of intra-abdominal infection in patients undergoing laparoscopic right hemicolectomy.
比较腹腔镜右半结肠切除术患者体内吻合（IA）与体外吻合（EA）术后30天内腹腔感染的差异。
回顾性分析2013年1月1日至2016年10月31日在北京大学人民医院结直肠外科行腹腔镜右半结肠切除术的右结肠癌患者的临床资料。排除无法根治性切除的IV期癌症患者、急诊手术患者及中转开腹手术患者。比较体内吻合与体外吻合在手术时间、术后感染及术后住院时间方面的差异。
本研究共纳入194例患者，其中IA组73例，EA组121例。两组患者在性别、年龄、既往手术史、肿瘤部位及肿瘤T分期方面差异均无统计学意义（均P>0.05）。两组患者的平均手术时间（162.4分钟 vs. 167.7分钟，P=0.257）、首次排气时间（3.3天 vs. 3.4天，P=0.744）、清扫淋巴结数目（30.3枚 vs. 33.8枚，P=0.071）及术后住院时间（7天 vs. 7天，P=0.067）差异均无统计学意义。IA组患者腹腔感染发生率显著高于EA组[13.7%（10/73） vs. 1.7%（2/121），P=0.001]，而伤口感染发生率[1.4%（1/73） vs. 3.3%（4/121），P=0.652]、呼吸道感染发生率[1.4%（1/73） vs. 3.3%（4/121），P=0.652]及尿路感染发生率[2.7%（2/73） vs. 0.8%（1/121），P=0.558]差异无统计学意义。
与EA相比，IA可能增加腹腔镜右半结肠切除术患者腹腔感染的风险。
