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应用倾向评分匹配分析比较腹腔镜右半结肠切除术与左半结肠切除术术后肠麻痹的发生率和危险因素:一项回顾性多中心研究。

Incidence of and risk factors for postoperative ileus between right and left laparoscopic colectomy using propensity-score-matched analysis: A retrospective multicenter study.

机构信息

Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Department of Surgery, Ureshino Medical Center, Saga, Japan.

出版信息

Asian J Endosc Surg. 2023 Oct;16(4):706-714. doi: 10.1111/ases.13227. Epub 2023 Jul 6.


DOI:10.1111/ases.13227
PMID:37409677
Abstract

INSTRUCTION: In colon cancer, the incidence of postoperative ileus is reportedly higher for the right-side than for the left-side colon, but those studies included small numbers of subjects and contained several biases. Furthermore, risk factors for postoperative ileus remain unclear. METHODS: This multicenter study reviewed 1986 patients who underwent laparoscopic colectomy between 2016 and 2021 for right-side (n = 907) and left-side (n = 1079) colon cancer. After propensity score matching, 803 patients in each group were matched. RESULTS: Postoperative ileus occurred in 97 patients. Before matching, the proportion of female patients and median age were higher and frequency of preoperative stent insertion was lower with right colectomy (P < .001 each). After matching, the number of retrieved lymph nodes (17 vs 15, P < .001) and greater rates of undifferentiated adenocarcinoma (10.6% vs 5.1%, P < .001) and postoperative ileus (6.4% vs 3.2%, P = .004) were higher in right colectomy. Multivariate analysis revealed male gender (hazard ratio, 1.798; 95% confidence interval, 1.049-3.082; P = .32) and history of abdominal surgery (hazard ratio, 1.909; 95% confidence interval, 1.073-3.395; P = .027) as independent predictors of postoperative ileus in right-side colon cancer. CONCLUSION: This study revealed a higher risk of postoperative ileus after right colectomy with laparoscopic surgery. Male gender and history of abdominal surgery were risk factors for postoperative ileus after right colectomy.

摘要

方法:这项多中心研究回顾了 2016 年至 2021 年间接受腹腔镜结肠切除术的 1986 例右侧(n=907)和左侧(n=1079)结肠癌患者。在倾向评分匹配后,每组匹配了 803 例患者。

结果:发生术后肠梗阻的患者有 97 例。在匹配前,右半结肠切除术的女性患者比例和中位年龄较高,术前支架置入的频率较低(P<.001)。匹配后,右半结肠切除术的淋巴结检出数量(17 枚 vs 15 枚,P<.001)、未分化腺癌的比例(10.6% vs 5.1%,P<.001)和术后肠梗阻的发生率(6.4% vs 3.2%,P=.004)更高。多因素分析显示,男性(风险比,1.798;95%置信区间,1.049-3.082;P=.32)和腹部手术史(风险比,1.909;95%置信区间,1.073-3.395;P=.027)是右侧结肠癌术后肠梗阻的独立预测因素。

结论:本研究显示腹腔镜右半结肠切除术后发生术后肠梗阻的风险较高。男性和腹部手术史是右半结肠切除术后发生术后肠梗阻的危险因素。

相似文献

[1]
Incidence of and risk factors for postoperative ileus between right and left laparoscopic colectomy using propensity-score-matched analysis: A retrospective multicenter study.

Asian J Endosc Surg. 2023-10

[2]
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World J Surg Oncol. 2022-3-4

[3]
Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis.

Surg Endosc. 2021-2

[4]
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[5]
Factors Determining Postoperative Ileus After Surgery for Colon Cancer: Comparison of Right- and Left-Sided Resections.

Surg Technol Int. 2022-5-19

[6]
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[7]
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[8]
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[9]
The effect of mechanical bowel preparation on postoperative complications in laparoscopic right colectomy: a retrospective propensity score matching analysis.

Int J Colorectal Dis. 2023-5-17

[10]
Increased incidence of prolonged ileus after colectomy for inflammatory bowel diseases under ERAS protocol: a cohort analysis.

J Surg Res. 2017-5-15

引用本文的文献

[1]
Risk factors for ileus after enhanced recovery robotic colectomy mediated by postoperative opioids: a single institution analysis.

Surg Endosc. 2025-5-2

[2]
Impact of Sidedness of Colon Cancer on Epidemiological, Clinical Presentation, Surgical, Pathological, and Oncologic Outcomes.

J Pers Med. 2024-12-16

[3]
Efficacy of Wuda Granule on Recovery of Gastrointestinal Function after Laparoscopic Bowel Resection: A Randomized Double-Blind Controlled Trial.

Chin J Integr Med. 2024-12

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