Department of Surgery, Helsingborg Hospital, Helsingborg, Lund University, Lund, Sweden.
Department of Surgery, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
World J Surg Oncol. 2021 Mar 19;19(1):82. doi: 10.1186/s12957-021-02193-7.
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.
Patients from the Swedish Colorectal Cancer Registry who underwent AR between 2007 and 2013 were analysed using multivariable methods.
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).
RW is a safe technique that does not increase the 30-day postoperative complication risk after AR with TME technique for rectal cancer.
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。
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。
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。
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。
