腹腔镜前切除术联合或不联合经肛管用于直肠癌患者的多中心随机对照试验。
Laparoscopic anterior resection with or without transanal tube for rectal cancer patients - A multicenter randomized controlled trial.
机构信息
Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan.
Department of Surgery, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan.
出版信息
Am J Surg. 2021 Sep;222(3):606-612. doi: 10.1016/j.amjsurg.2020.12.054. Epub 2021 Jan 2.
BACKGROUND
In rectal cancer surgery, insertion of transanal tube has been shown to have efficacy to prevent anastomotic leakage. This randomized controlled study aims to clarify the incidence of anastomotic leakage with or without transanal tube in patients with rectal cancer.
METHODS
Patients who underwent elective low anterior resection were randomly allocated to either have transanal tube insertion or not for five days after surgery. We examined the incidence of anastomotic leakage, postoperative 30-day morbidity and mortality.
RESULTS
157 patients were randomized to the transanal tube group or the no-transanal tube group. Symptomatic anastomotic leakage occurred in six patients (7.6%) of the former group and eight patients (10.3%) in the latter group, without significant difference (p = 0.559). There was also no significant difference in morbidity between groups (p = 0.633) and no mortality was detected.
CONCLUSIONS
Transanal tube insertion had no significant benefit towards prevention of anastomotic leakage in rectal cancer surgery.
背景
在直肠癌手术中，插入经肛门管已被证明能有效预防吻合口漏。这项随机对照研究旨在明确直肠癌患者使用或不使用经肛门管的吻合口漏发生率。
方法
接受择期低位前切除术的患者被随机分配在手术后五天内插入经肛门管或不插入。我们检查了吻合口漏、术后 30 天发病率和死亡率的发生情况。
结果
157 名患者被随机分配到经肛门管组或无经肛门管组。前者组有 6 名（7.6%）患者出现症状性吻合口漏，后者组有 8 名（10.3%）患者出现症状性吻合口漏，差异无统计学意义（p=0.559）。两组之间的发病率也没有显著差异（p=0.633），也没有死亡病例。
结论
在直肠癌手术中，插入经肛门管对预防吻合口漏没有显著益处。
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