Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Neonatology, Tianjin Children's Hospital, Tianjin, China.
Asia Pac J Clin Oncol. 2020 Dec;16(6):326-332. doi: 10.1111/ajco.13372. Epub 2020 Jun 7.
Natural orifice specimen extraction (NOSE) surgery has been widely implemented in colorectal cancer surgery due to its good short-term efficacy. However, anastomotic leakage (AL) is a serious postoperative complication in colorectal cancer, and the risk factors for this complication after NOSE surgery have rarely been investigated. The aim of this study was to explore the predictive factors for AL after laparoscopic resection with transrectal NOSE for rectal cancer and sigmoid colon cancer.
A total of 208 patients who underwent total laparoscopic resection with transrectal NOSE for rectal cancer and sigmoid colon cancer from January 2014 to June 2019 were systematically reviewed. Univariate and multivariate analyses were performed to identify the relevant risk factors.
The rate of AL was 10.1% (21 of 208 patients). The univariate analyses showed that male sex (85.7% vs 57.8%, P = .013), the distance from the anal verge (10.5 vs 14.5 cm, P = .011), and a duration of operation ≥140 min (71.4% vs 29.4%, P<.001) were associated with an increased incidence of AL. The multivariate analysis showed that a duration of operation ≥140 min (OR = 5427, 95% CI = 1.355-21.727, P = .017) was an independent risk factor for AL.
A duration of operation ≥140 min is a possible risk factor for AL after total laparoscopic resection with transrectal NOSE for colorectal cancer.
由于其良好的短期疗效，自然腔道标本提取（NOSE）手术已广泛应用于结直肠癌手术。然而，吻合口漏（AL）是结直肠癌术后的一种严重并发症，NOSE 手术后发生这种并发症的危险因素很少被研究。本研究旨在探讨经直肠 NOSE 腹腔镜直肠和乙状结肠癌根治术后 AL 的预测因素。
对 2014 年 1 月至 2019 年 6 月间接受全腹腔镜经直肠 NOSE 直肠和乙状结肠癌根治术的 208 例患者进行系统回顾。采用单因素和多因素分析确定相关危险因素。
AL 发生率为 10.1%（21/208 例）。单因素分析显示，男性（85.7%比 57.8%，P=.013）、距肛缘距离（10.5 比 14.5cm，P=.011）和手术时间≥140min（71.4%比 29.4%，P<.001）与 AL 发生率增加有关。多因素分析显示，手术时间≥140min（OR=5427，95%CI=1.355-21.727，P=.017）是 AL 的独立危险因素。
手术时间≥140min 是经直肠 NOSE 腹腔镜结直肠肿瘤根治术后 AL 的可能危险因素。
