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腹腔镜辅助右半结肠癌根治术采用改良三角形吻合术或管状吻合术患者术后恢复情况的比较:一项回顾性队列研究

Comparison of postoperative recovery of patients who underwent laparoscopic-assisted radical resection of right colon cancer with modified triangular anastomosis or tubular anastomosis: a retrospective cohort study.

作者信息

Xia Tianfang, Pan Zhenguo, Zhang Jie, Xu Guo

机构信息

Department of General Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, No. 6 Beijing West Road, Huaiyin, Huaian, 223300, Jiangsu, China.

Department of Gastroenterology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China.

出版信息

BMC Surg. 2021 Feb 10;21(1):77. doi: 10.1186/s12893-021-01086-6.

Abstract

BACKGROUND

We compared the advantages and disadvantages of modified triangular anastomosis and tubular anastomosis for digestive tract reconstruction in patients undergoing laparoscopic-assisted radical resection of right colon cancer.

METHODS

This was a retrospective cohort analysis of 92 cases of laparoscopic-assisted resection of right colon cancer, treated from June 2017 to June 2018, at the Huai'an No. 1 People's Hospital in China. Patients were divided into a modified triangular anastomosis group (n = 33) and a tubular anastomosis group (n = 59). In the modified triangular anastomosis group, digestive tract reconstruction was conducted using side-to-side anastomosis of the ileo-transverse colon with a 60-mm linear stapler. The common entry hole was closed with a running suture. The tubular anastomosis group underwent end-to-side anastomosis of the ileo-transverse colon with a tubular stapler anchor placed at the end of the ileum.

RESULTS

At baseline and perioperatively, there were no significant between-group differences in age, sex, body mass index, tumor location, pathological stage, or tumour size (P > 0.05). There were also no significant between-group differences in operation time, estimated blood loss, the number of harvested lymph nodes, the first postoperative flatulence time, hospitalisation time, or postoperative complications (P > 0.05); however, the total cost of hospitalization for the triangular anastomosis group was significantly lower than the tubular anastomosis group (P < 0.05).

CONCLUSION

Modified triangular anastomosis is a safe and feasible procedure for laparoscopic-assisted radical resection of right colon cancer. These results affirm the safety and effectiveness of total laparoscopic radical resection of right colon cancer. Given the equivalent outcomes between the two procedures, the modified triangular procedure may be more a more cost-effective option for clinical application.

摘要

背景

我们比较了改良三角形吻合术和管状吻合术在腹腔镜辅助右半结肠癌根治性切除患者消化道重建中的优缺点。

方法

这是一项对2017年6月至2018年6月在中国淮安市第一人民医院接受腹腔镜辅助右半结肠癌切除术的92例患者进行的回顾性队列分析。患者分为改良三角形吻合术组(n = 33)和管状吻合术组(n = 59)。在改良三角形吻合术组中,使用60毫米线性吻合器进行回肠横结肠侧侧吻合来进行消化道重建。共同入口用连续缝合关闭。管状吻合术组使用管状吻合器在回肠末端放置锚钉进行回肠横结肠端侧吻合。

结果

在基线和围手术期,两组在年龄、性别、体重指数、肿瘤位置、病理分期或肿瘤大小方面无显著差异(P > 0.05)。两组在手术时间、估计失血量、收获的淋巴结数量、术后首次排气时间、住院时间或术后并发症方面也无显著差异(P > 0.05);然而,三角形吻合术组的住院总费用显著低于管状吻合术组(P < 0.05)。

结论

改良三角形吻合术是腹腔镜辅助右半结肠癌根治性切除的一种安全可行的手术方法。这些结果证实了全腹腔镜右半结肠癌根治性切除的安全性和有效性。鉴于两种手术效果相当,改良三角形手术可能是更具成本效益的临床应用选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/498d/7877016/f4c7682067c8/12893_2021_1086_Fig1_HTML.jpg

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