直肠冲洗并不会增加直肠癌前切除术后的并发症风险。
Rectal washout does not increase the complication risk after anterior resection for rectal cancer.
机构信息
Department of Surgery, Helsingborg Hospital, Helsingborg, Lund University, Lund, Sweden.
Department of Surgery, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
出版信息
World J Surg Oncol. 2021 Mar 19;19(1):82. doi: 10.1186/s12957-021-02193-7.
BACKGROUND
To reduce local recurrence risk, rectal washout (RW) is integrated in the total mesorectal excision (TME) technique when performing anterior resection (AR) for rectal cancer. Although RW is considered a safe practice, data on the complication risk are scarce. Our aim was to examine the association between RW and 30-day postoperative complications after AR for rectal cancer.
METHODS
Patients from the Swedish Colorectal Cancer Registry who underwent AR between 2007 and 2013 were analysed using multivariable methods.
RESULTS
A total of 4821 patients were included (4317 RW, 504 no RW). The RW group had lower rates of overall complications (1578/4317 (37%) vs. 208/504 (41%), p = 0.039), surgical complications (879/4317 (20%) vs. 140/504 (28%), p < 0.001) and 30-day mortality (50/4317 (1.2%) vs. 12/504 (2.4%), p = 0.020). In multivariable analysis, RW was a risk factor neither for overall complications (OR 0.73, 95% CI 0.60-0.90, p = 0.002) nor for surgical complications (OR 0.62, 95% CI 0.50-0.78, p < 0.001).
CONCLUSIONS
RW is a safe technique that does not increase the 30-day postoperative complication risk after AR with TME technique for rectal cancer.
背景
为降低局部复发风险，在直肠前切除术（AR）中行全直肠系膜切除术（TME）时，常合并直肠冲洗（RW）。尽管 RW 被认为是一种安全的操作，但有关其并发症风险的数据却很少。我们旨在研究 RW 与直肠癌 AR 术后 30 天内并发症之间的关系。
方法
使用多变量方法分析了 2007 年至 2013 年期间在瑞典结直肠癌登记处接受 AR 的患者数据。
结果
共纳入 4821 例患者（RW 组 4317 例，无 RW 组 504 例）。RW 组的总体并发症发生率较低（37%[4317/4317] vs. 41%[208/504]，p=0.039）、手术并发症发生率较低（20%[879/4317] vs. 28%[140/504]，p<0.001）和 30 天死亡率较低（1.2%[50/4317] vs. 2.4%[12/504]，p=0.020）。多变量分析显示，RW 既不是总体并发症（OR 0.73，95%CI 0.60-0.90，p=0.002）的危险因素，也不是手术并发症（OR 0.62，95%CI 0.50-0.78，p<0.001）的危险因素。
结论
RW 是一种安全的技术，在 AR 中联合 TME 技术治疗直肠癌不会增加 30 天术后并发症风险。
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