Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Department of General Surgery, Qijiang District People's Hospital, Chongqing, 401420, China.
BMC Surg. 2022 Jul 7;22(1):263. doi: 10.1186/s12893-022-01715-8.
The purpose of the current study was to compare the outcomes of temporary stoma through the specimen extraction site (SSES) and stoma through a new site (SNS) after laparoscopic low anterior resection.
The rectal cancer patients who underwent laparoscopic low anterior resection plus temporary ileostomy were recruited in a single clinical database from Jun 2013 to Jun 2020. The SSES group and the SNS group were compared using propensity score matching (PSM) analysis.
A total of 257 rectal cancer patients were included in this study, there were 162 patients in the SSES group and 95 patients in the SNS group. After 1:1 ratio PSM, there was no difference in baseline information (p > 0.05). The SSES group had smaller intraoperative blood loss (p = 0.016 < 0.05), shorter operation time (p < 0.01) and shorter post-operative hospital stay (p = 0.021 < 0.05) than the SNS group before PSM. However, the SSES group shorter operation time (p = 0.006 < 0.05) than the SNS group after PSM, moreover, there was no significant difference in stoma-related complications (p > 0.05). In the multivariate analysis, longer operation time was an independent factor (p = 0.019 < 0.05, OR = 1.006, 95% CI = 1.001-1.011) for the stoma-related complications.
Based on the current evidence, the SSES group had smaller intraoperative blood loss, shorter operation time and shorter post-operative hospital stay before PSM, and shorter operation time after PSM. Therefore, SSES might be superior than SNS after laparoscopic low anterior resection for rectal cancer patients.
本研究旨在比较腹腔镜低位前切除术后经标本取出部位造口（SSES）和新部位造口（SNS）的结局。
从 2013 年 6 月至 2020 年 6 月，在一个单一的临床数据库中招募接受腹腔镜低位前切除加临时肠造口术的直肠癌患者。采用倾向评分匹配（PSM）分析比较 SSES 组和 SNS 组。
本研究共纳入 257 例直肠癌患者，SSES 组 162 例，SNS 组 95 例。1:1 比例 PSM 后，两组基线资料无差异（p>0.05）。SSES 组术中出血量较少（p=0.016<0.05），手术时间较短（p<0.01），术后住院时间较短（p=0.021<0.05），但 SSES 组手术时间较短（p=0.006<0.05）。然而，PSM 后 SSES 组手术时间较短（p=0.006<0.05），两组造口相关并发症无差异（p>0.05）。多因素分析显示，手术时间较长是造口相关并发症的独立因素（p=0.019<0.05，OR=1.006，95%CI=1.001-1.011）。
根据目前的证据，PSM 前 SSES 组术中出血量较少，手术时间较短，术后住院时间较短，PSM 后手术时间较短。因此，SSES 可能优于 SNS 用于腹腔镜低位前切除术后的直肠癌患者。
