Department of General and Gastroenterological Surgery, Tokai University Hachioji Hospital, Tokyo, Japan
Department of General and Gastroenterological Surgery, Tokai University Hachioji Hospital, Tokyo, Japan.
Anticancer Res. 2019 Nov;39(11):6393-6401. doi: 10.21873/anticanres.13853.
BACKGROUND/AIM: Intracorporeal anastomosis (IA) in laparoscopic colectomy for colon cancer is technically difficult, and there is a lack of consensus on the risk of bacterial contamination and cancer cell dissemination. In this study, short- and long-term outcomes of IA were examined.
Short and long-term outcomes of those who underwent IA (n=44) or extracorporeal anastomosis (EA) (n=61) were compared.
IA was better than EA for blood loss, incision length, and first stool. Maximum temperature and C-reactive protein on postoperative day 1 were higher for the IA group. The rate of positive cultures from intraoperative lavage was higher for IA. The rate of positive cultures improved to an equivalent level by replacing mechanical pretreatment with chemical pretreatment. IA and EA were equivalent for the results of ascites cytology from lavage.
With the use of appropriate preoperative treatment, IA takes advantage of the minimally invasive nature of laparoscopic surgery.
背景/目的：腹腔镜结肠癌手术中的腔内吻合（IA）技术难度较大，关于细菌污染和癌细胞播散的风险尚无共识。本研究检查了 IA 的短期和长期结果。
比较了行 IA（n=44）或 EA（n=61）的患者的短期和长期结果。
IA 在出血量、切口长度和首次排便方面优于 EA。IA 组术后第 1 天的最高体温和 C 反应蛋白更高。IA 术中灌洗的阳性培养率更高。通过用化学预处理代替机械预处理，阳性培养率提高到相同水平。IA 和 EA 在灌洗腹水细胞学检查结果方面相当。
通过使用适当的术前治疗，IA 利用了腹腔镜手术的微创特性。
