直肠癌经肛门内镜微创手术（endoscopic abdominoperineal excision，EAPE）后会阴疝的术后危险因素回顾性分析。
Retrospective analysis of risk factors for postoperative perineal hernia after endoscopic abdominoperineal excision for rectal cancer.
机构信息
Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
出版信息
BMC Surg. 2022 Mar 8;22(1):88. doi: 10.1186/s12893-022-01538-7.
BACKGROUND
In contrast to open-surgery abdominoperineal excision (APE) for rectal cancer, postoperative perineal hernia (PPH) is reported to increase after extralevator APE and endoscopic surgery. In this study, therefore, we aimed to determine the risk factors for PPH after endoscopic APE.
METHODS
A total 73 patients who underwent endoscopic APE for rectal cancer were collected from January 2009 to March 2020, and the risk factors for PPH were analyzed retrospectively.
RESULTS
Nineteen patients (26%) developed PPH after endoscopic APE, and the diagnosis of PPH was made at 9-393 days (median: 183 days) after initial surgery. Logistic regression analysis showed that absence of pelvic peritoneal closure alone increased the incidence of PPH significantly (odds ratio; 13.76, 95% confidence interval; 1.48-1884.84, p = 0.004).
CONCLUSIONS
This preliminary study showed that pelvic peritoneal closure could prevent PPH after endoscopic APE.
背景
与直肠癌开放式经腹会阴切除术（APE）相比，经肛提肌外 APE 和内镜手术后，报道会阴疝（PPH）的发生率增加。因此，在这项研究中，我们旨在确定内镜 APE 后 PPH 的危险因素。
方法
本研究回顾性分析了 2009 年 1 月至 2020 年 3 月期间因直肠癌接受内镜 APE 的 73 例患者的资料，分析 PPH 的危险因素。
结果
19 例（26%）患者在接受内镜 APE 后发生 PPH，首次手术后的诊断时间为 9-393 天（中位数：183 天）。Logistic 回归分析显示，单独缺乏盆腹膜关闭会显著增加 PPH 的发生率（比值比；13.76，95%置信区间；1.48-1884.84，p=0.004）。
结论
这项初步研究表明，盆腹膜关闭可以预防内镜 APE 后 PPH 的发生。
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