新辅助放化疗后腹会阴切除术中应用大网膜成形术减少会阴部伤口并发症的效果。

Usefulness of Omentoplasty to Reduce Perineal Wound Complications in Abdominoperineal Resection After Neoadjuvant Chemoradiotherapy.

机构信息

Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

出版信息

Anticancer Res. 2020 Nov;40(11):6539-6543. doi: 10.21873/anticanres.14678.

DOI:10.21873/anticanres.14678

PMID:33109595

Abstract

BACKGROUND

Omentoplasty is sometimes used to prevent perineal wound complications after abdominoperineal resection (APR) following neoadjuvant chemoradiotherapy (NACRT). However, recent studies have raised some controversy about its clinical benefit.

PATIENTS AND METHODS

Outcomes for rectal cancer patients who received APR after NACRT were retrospectively compared between the groups with omentoplasty (n=28) and without omentoplasty (n=14).

RESULTS

The operative time was significantly longer in the omentoplasty group (575 vs. 404 min, p<0.001). Laparoscopic surgery was performed more frequently in the omentoplasty group. Perineal wound problems including dehiscence and infection were significantly reduced in the omentoplasty group (46.4% vs. 78.6%, p<0.001). Univariate and multivariate analyses revealed that omentoplasty was the most important factor in reducing perineal wound complications (odds ratio=0.020, 95% confidence intervaI=0.001-0.393; p=0.001).

CONCLUSION

Omentoplasty was useful in reducing perineal wound complications after APR following NACRT.

摘要

背景

在新辅助放化疗（NACRT）后行腹会阴切除术（APR）时，网膜切除术有时用于预防会阴伤口并发症。然而，最近的一些研究对其临床获益提出了一些争议。

患者和方法

回顾性比较了接受 NACRT 后行 APR 的直肠癌患者中接受网膜切除术（n=28）和未接受网膜切除术（n=14）两组的结局。

结果

网膜切除术组的手术时间明显更长（575 分钟 vs. 404 分钟，p<0.001）。网膜切除术组更常进行腹腔镜手术。网膜切除术组会阴伤口问题（包括裂开和感染）明显减少（46.4% vs. 78.6%，p<0.001）。单因素和多因素分析显示，网膜切除术是减少会阴伤口并发症的最重要因素（比值比=0.020，95%置信区间为 0.001-0.393；p=0.001）。