Department of Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan.
Surg Today. 2022 Apr;52(4):616-623. doi: 10.1007/s00595-021-02375-6. Epub 2021 Oct 20.
To compare the postoperative short-term results of intracorporeal anastomosis (IA) using overlap anastomosis (OLA), with those of extracorporeal anastomosis (EA) using functional end-to-end anastomosis (FEEA) or hand-sewn anastomosis (HSA), after laparoscopic colectomy (LAC).
The subjects of this retrospective study were 208 patients with colon cancer who underwent OLA, FEEA, or HSA after LAC at our institution, between 2018 and 2021. The short-term results of the OLA group were compared with those of the FEEA and HSA groups, respectively, using a propensity score-matching method.
The mean operative time for anastomosis was longer in the OLA group than in the FEEA and HSA groups (p < 0.0001). The mean blood loss volume was less in the OLA group than in the FEEA and HSA groups (p = 0.0344 and p = 0.0002, respectively). The mean skin incision size was smaller in the OLA group than in the FEEA and HSA groups (p < 0.0001 and p = 0.0031, respectively). None of the patients in the OLA group had surgical site infections. Three to five patients were required for the surgeon to plateau on the learning curve.
Although IA required more time than EA, the skills appeared to improve with experience and the short-term results were superior to those of EA.
比较腹腔镜结肠切除术（LAC）后行腔内吻合（IA）重叠吻合（OLA）与行体外吻合（EA）行端端功能性吻合（FEEA）或手工吻合（HSA）的术后短期结果。
本回顾性研究的对象为 2018 年至 2021 年期间在我院行 OLA、FEEA 或 HSA 的 208 例结肠癌患者。采用倾向评分匹配法，将 OLA 组的短期结果分别与 FEEA 组和 HSA 组进行比较。
OLA 组吻合术的平均手术时间长于 FEEA 组和 HSA 组（p<0.0001）。OLA 组的平均出血量少于 FEEA 组和 HSA 组（p=0.0344 和 p=0.0002）。OLA 组的平均皮肤切口大小小于 FEEA 组和 HSA 组（p<0.0001 和 p=0.0031）。OLA 组无 1 例发生手术部位感染。术者的学习曲线需要 3 到 5 例患者才能达到平台期。
虽然 IA 比 EA 需要更多的时间，但随着经验的积累，技能似乎有所提高，且短期结果优于 EA。
