Department of General Surgery, Shanghai Jiao Tong University, Shanghai, 200025, China.
Shanghai Minimally Invasive Surgery Center, Shanghai Jiao Tong University, Shanghai, China.
J Surg Oncol. 2021 May;123 Suppl 1:S81-S87. doi: 10.1002/jso.26333. Epub 2021 Mar 19.
To investigate the effects of different suture reinforcement methods for anastomotic leakage and other postoperative complications after the use of a laparoscopic double stapling technique (DST).
We collected the data of 124 patients who underwent laparoscopic radical resection of colorectal cancer from July 2017 to September 2018 at our institution. Patients were divided into three groups according to the suture reinforcement methods: intermittent, continuous suture reinforcement, and non-reinforcement (n = 41, 41, and 42, respectively). One-way analysis of variance, χ , Fisher's exact, and nonparametric tests were used for statistical analysis.
Among the 124 patients, there were no statistically significant differences in operation times, intraoperative blood loss, postoperative hospital stays and recovery of bowel movement. Nine patients were diagnosed with anastomotic leakage (AL). The incidences of serious AL in the intermittent and continuous suture reinforcement groups were lower than that in the control group, with lower reoperation rate, shorter average lengths of stay and lower treatment costs of two experimental groups.
Intermittent and continuous sutures after laparoscopic DST is effective, safe, and feasible on anastomotic leakage prevention. These procedures could be popularized in rectal surgery on patients with high risk of AL.
研究腹腔镜双吻合器技术（DST）使用后不同吻合口加固方法对吻合口漏和其他术后并发症的影响。
我们收集了 2017 年 7 月至 2018 年 9 月我院 124 例行腹腔镜结直肠癌根治术患者的数据。根据吻合口加固方法将患者分为三组：间断缝合加固组、连续缝合加固组和非加固组（n=41、41、42）。采用单因素方差分析、卡方检验、Fisher 确切概率法和非参数检验进行统计学分析。
124 例患者中，手术时间、术中出血量、术后住院时间和肠蠕动恢复无统计学差异。9 例患者诊断为吻合口漏（AL）。间断缝合加固组和连续缝合加固组严重 AL 的发生率低于对照组，两组的再次手术率较低，平均住院时间较短，治疗费用较低。
腹腔镜 DST 后间断和连续缝合预防吻合口漏是有效、安全和可行的。对于有高吻合口漏风险的患者，这些操作可以在直肠手术中推广。
