全腹腔镜下右半结肠切除术的吻合方法：来自加拿大中心的经验。
Total intracorporeal anastomosis for right hemicolectomy: Experience from a Canadian center.
机构信息
Richmond Hospital, 7000 Westminster Highway, Richmond, British Columbia, V6X 1A2, Canada.
University of British Columbia, 2329 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada.
出版信息
Am J Surg. 2018 May;215(5):905-908. doi: 10.1016/j.amjsurg.2018.02.013. Epub 2018 Feb 27.
BACKGROUND
Laparoscopic right hemicolectomy (LRHC) techniques have varied in the approach to anastomosis. We compared outcomes of laparoscopic right hemicolectomy with extracorporeal anastomosis (ECA) versus intracorporeal anastomosis (ICA).
METHODS
We retrospectively reviewed all LRHCs conducted at Richmond Hospital between January 2015 and October 2017. We compared the demographic, pathologic, intraoperative, and postoperative data.
RESULTS
74 LRHCs were included during the study period: 56 ECA and 18 ICA. The groups were comparable in age, gender, tumor staging, and tumor location. Incidence of clinical ileus was significantly less for ICA (0% vs. 21%, p = 0.032). Mean length of stay was significantly shorter for ICA (3.13 vs. 4.82 days, p = 0.003). There was no difference between ICA and ECA in mean operative time (158 vs. 145 min, p = 0.087), surgical site infections (6% vs. 4%, p = 1.0), emergency department visits within 30 days (5% vs. 6%, p = 1.0), and hospital readmission within 30 days (4% vs 0%, p = 1.0). There were no incidences of anastomotic leaks, perioperative deaths, or cardiopulmonary complications in either group.
CONCLUSIONS
An ICA approach to LRHC results in shorter hospital stay and decreased rates of clinical ileus.
背景
腹腔镜右半结肠切除术（LRHC）的吻合技术在入路方面存在差异。我们比较了腹腔镜右半结肠切除术体外吻合（ECA）与体内吻合（ICA）的结果。
方法
我们回顾性分析了 2015 年 1 月至 2017 年 10 月在里士满医院进行的所有 LRHC。我们比较了两组的人口统计学、病理、术中及术后资料。
结果
研究期间共进行了 74 例 LRHC：56 例 ECA 和 18 例 ICA。两组在年龄、性别、肿瘤分期和肿瘤位置方面具有可比性。ICA 组的临床性肠梗阻发生率明显较低（0%比 21%，p=0.032）。ICA 组的平均住院时间明显缩短（3.13 天比 4.82 天，p=0.003）。ICA 和 ECA 之间的手术时间（158 分钟比 145 分钟，p=0.087）、手术部位感染（6%比 4%，p=1.0）、30 天内急诊就诊（5%比 6%，p=1.0）和 30 天内院内再入院（4%比 0%，p=1.0）无差异。两组均无吻合口漏、围手术期死亡或心肺并发症。
结论
LRHC 的 ICA 方法可缩短住院时间并降低临床性肠梗阻的发生率。
Zotero 插件