Bao M D L, Su H, Luo S, Xu Z, Wang X W, Liu Q, Zhou Z X, Wang X S, Zhou H T
Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2022 May 23;44(5):436-441. doi: 10.3760/cma.j.cn112152-20200714-00655.
To explore the clinical safety and feasibility of overlapped delta-shaped anastomosis (ODA) in totally laparoscopic right hemicolectomy (TLRHC). From May 2017 to October 2019, of the 219 patients who underwent TLRHC at the Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 104 cases underwent ODA (ODA group) and 115 cases underwent conventional extracorporeal anastomosis (control group) were compared the surgical outcomes, postoperative recovery, pathological outcomes and perioperative complications. The length of the skin incision in the ODA group was significantly shorter than that in the control group [(5.6±0.9) cm vs. (7.1±1.7) cm, <0.05], and the time to first flatus and first defecation after surgery in the ODA group was significantly earlier than that in the control group [(1.7±0.7) days vs. (2.0±0.7) days; (3.2±0.6) days vs. (3.3±0.7) days, <0.05]. While the anastomosis time, operation time, intraoperative blood loss, the time of first ground activities, the number of bowel movements within 12 days after surgery, postoperative hospital stay, tumor size, the distal and proximal margins, the number of lymph node harvested and postoperative TNM stage in the ODA group did not differ from that of the control group (>0.05). The postoperative complication rates of patients in the ODA group and the control group were 3.8% (4/104) and 4.3% (5/115), respectively, and the difference was not significant (>0.05). The application of ODA technology in TLRHC can significantly shorten thelength of skin incisionand the recovery time of bowel function, and can obtain satisfactory short-term efficacy.
探讨重叠三角吻合术(ODA)在完全腹腔镜右半结肠切除术(TLRHC)中的临床安全性和可行性。2017年5月至2019年10月,在中国医学科学院肿瘤医院、北京协和医学院接受TLRHC的219例患者中,104例行ODA(ODA组),115例行传统体外吻合术(对照组),比较两组手术效果、术后恢复情况、病理结果及围手术期并发症。ODA组皮肤切口长度明显短于对照组[(5.6±0.9)cm对(7.1±1.7)cm,<0.05],ODA组术后首次排气和首次排便时间明显早于对照组[(1.7±0.7)天对(2.0±0.7)天;(3.2±0.6)天对(3.3±0.7)天,<0.05]。而ODA组的吻合时间、手术时间、术中出血量、首次下地活动时间、术后12天内排便次数、术后住院时间、肿瘤大小、切缘远近端、淋巴结清扫数目及术后TNM分期与对照组比较差异无统计学意义(>0.05)。ODA组和对照组患者术后并发症发生率分别为3.8%(4/104)和4.3%(5/115),差异无统计学意义(>0.05)。ODA技术应用于TLRHC可显著缩短皮肤切口长度和肠功能恢复时间,并可获得满意的短期疗效。