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腹腔镜体外吻合术治疗横结肠癌的短期和长期疗效:三角吻合术与功能性端端吻合术的比较

Short- and long-term outcomes of laparoscopic surgery with extracorporeal anastomosis for transverse colon cancer: comparison of triangulating anastomosis with functional end-to-end anastomosis.

作者信息

Emoto Shin, Fukunaga Yosuke, Nakanishi Ryota, Hirayama Kazuyoshi, Nagaoka Tomoyuki, Matsui Shimpei, Mukai Toshiki, Nagasaki Toshiya, Yamaguchi Tomohiro, Akiyoshi Takashi, Konishi Tsuyoshi, Nagayama Satoshi, Ueno Masashi

机构信息

Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.

Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Surg Endosc. 2022 May;36(5):3261-3269. doi: 10.1007/s00464-021-08638-0. Epub 2021 Aug 2.

Abstract

BACKGROUND

We compared triangulating anastomosis (TRI) with functional end-to-end anastomosis (FEEA) in terms of patient demographics, clinicopathological features, and short- and long-term outcomes in this study.

METHODS

From November 2005 to May 2016, 315 patients with transverse colon cancer underwent laparoscopic resection. TRI was performed in 62 patients and FEEA in 253 patients. Patients with another concomitant cancer, who received neoadjuvant chemotherapy, and/or who underwent another operation at the same time were excluded.

RESULTS

The patients' backgrounds were comparable in each group. Transverse colectomy was selected more frequently in TRI and right hemicolectomy in FEEA. The operation time was shorter in TRI. The rate of anastomotic leakage was comparable (1.6% in TRI vs. 0.8% in FEEA). Stricture was more common in TRI (8.1% vs. 0%) and bleeding was more common in FEEA (1.6% vs. 10.6%). The rate of long-term complications was comparable in each group. Overall survival of stage 0-III patients was comparable in each group (94.7% in TRI vs. 93.7% in FEEA). 5-year disease-free survival of stage 0-III, stage II, and stage III patients was also comparable in each group (94.8% vs. 93.0%, 100% vs. 92.1%, and 80.3% vs. 79.2% in TRI and FEEA, respectively).

CONCLUSION

The short- and long-term outcome rates were acceptable in both groups. Specific attempts to prevent complications are required for each anastomotic procedure.

摘要

背景

在本研究中,我们比较了三角形吻合术(TRI)与功能性端端吻合术(FEEA)在患者人口统计学、临床病理特征以及短期和长期结局方面的差异。

方法

2005年11月至2016年5月,315例横结肠癌患者接受了腹腔镜切除术。62例患者接受了三角形吻合术,253例患者接受了功能性端端吻合术。排除患有其他伴随癌症、接受新辅助化疗和/或同时接受其他手术的患者。

结果

每组患者的背景具有可比性。三角形吻合术组更常选择横结肠切除术,功能性端端吻合术组更常选择右半结肠切除术。三角形吻合术的手术时间更短。吻合口漏发生率相当(三角形吻合术组为1.6%,功能性端端吻合术组为0.8%)。狭窄在三角形吻合术组更常见(8.1%对0%),出血在功能性端端吻合术组更常见(1.6%对10.6%)。每组的长期并发症发生率相当。0-III期患者的总生存率在每组中相当(三角形吻合术组为94.7%,功能性端端吻合术组为93.7%)。0-III期、II期和III期患者的5年无病生存率在每组中也相当(三角形吻合术组和功能性端端吻合术组分别为94.8%对93.0%、100%对92.1%、80.3%对79.2%)。

结论

两组的短期和长期结局率均可接受。每种吻合手术都需要采取特定措施预防并发症。

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