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胶原贴片覆盖有助于腹腔镜结肠切除术后肠道功能的恢复。

Collagen patch cover facilitates recovery of bowel function after laparoscopic colectomy.

机构信息

Department of General Medicine, Taipei Medical University Shuang-Ho Hospital, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan.

Department of General Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi County, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan.

出版信息

BMC Surg. 2024 Feb 20;24(1):66. doi: 10.1186/s12893-024-02339-w.


DOI:10.1186/s12893-024-02339-w
PMID:38378522
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10880318/
Abstract

BACKGROUND: Numerous factors can influence bowel movement recovery and anastomotic healing in colorectal surgery, and poor healing can lead to severe complications and increased medical expenses. Collagen patch cover (CPC) is a promising biomaterial that has been demonstrated to be safe in animal models and has been successfully applied in various surgical procedures in humans. This study. METHODS: A retrospective review of medical records from July 2020 to June 2022 was conducted to identify consecutive patients who underwent laparoscopic colectomy. Patients who received CPC at the anastomotic site were assigned to the collagen group, whereas those who did not receive CPC were assigned to the control group. RESULTS: Data from 241 patients (collagen group, 109; control group, 132) were analyzed. Relative to the control group, the collagen group exhibited a faster recovery of bowel function, including an earlier onset of first flatus (2.93 days vs. 3.43 days, p < 0.01), first defecation (3.73 days vs. 4.18 days, p = 0.01), and oral intake (4.30 days vs. 4.68 days, p = 0.04). CPC use was also associated with lower use of postoperative intravenous analgesics. The complication rates in the two groups did not differ significantly. CONCLUSIONS: CPCs can be safely and easily applied to the anastomotic site during laparoscopic colectomy, and can accelerate bowel movement recovery. Further studies on the effectiveness of CPCs in colorectal surgery involving larger sample sizes are required. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov registration number: NCT05831956 (26/04/2023).

摘要

背景:许多因素会影响结直肠手术中的肠道运动恢复和吻合口愈合,而愈合不良会导致严重的并发症和增加医疗费用。胶原贴(CPC)是一种有前途的生物材料,已在动物模型中证明安全,并已成功应用于人体各种手术中。本研究。

方法:对 2020 年 7 月至 2022 年 6 月期间接受腹腔镜结肠切除术的连续患者的病历进行回顾性分析。在吻合部位接受 CPC 的患者被分配到胶原组,而未接受 CPC 的患者被分配到对照组。

结果:对 241 名患者(胶原组 109 例,对照组 132 例)的数据进行了分析。与对照组相比,胶原组肠道功能恢复更快,首次排气(2.93 天比 3.43 天,p<0.01)、首次排便(3.73 天比 4.18 天,p=0.01)和口服摄入(4.30 天比 4.68 天,p=0.04)更早。术后静脉内镇痛剂的使用也与 CPC 的使用相关。两组的并发症发生率无显著差异。

结论:CPC 可在腹腔镜结肠切除术中安全且易于应用于吻合部位,并可加速肠道运动恢复。需要更大样本量的涉及结直肠手术中 CPC 有效性的进一步研究。

临床试验注册:ClinicalTrials.gov 注册号:NCT05831956(2023 年 4 月 26 日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dc0/10880318/3e8bb2345112/12893_2024_2339_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dc0/10880318/69a1b2f5fd7e/12893_2024_2339_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dc0/10880318/3e8bb2345112/12893_2024_2339_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dc0/10880318/69a1b2f5fd7e/12893_2024_2339_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dc0/10880318/3e8bb2345112/12893_2024_2339_Fig2_HTML.jpg

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本文引用的文献

[1]
C-reactive Protein and Procalcitonin Levels to Predict Anastomotic Leak After Colorectal Surgery: Systematic Review and Meta-analysis.

J Gastrointest Surg. 2023-1

[2]
Intestinal Anastomotic Healing: What do We Know About Processes Behind Anastomotic Complications.

Front Surg. 2022-6-7

[3]
Application of collagen matrix in the prevention of anastomotic leaks following D2 gastrectomy with Roux-en-Y anastomosis.

Pol Przegl Chir. 2021-12-30

[4]
Anastomotic leakage in colorectal cancer surgery.

Surg Oncol. 2022-3

[5]
STROCSS 2021: Strengthening the reporting of cohort, cross-sectional and case-control studies in surgery.

Int J Surg. 2021-12

[6]
Collagen in Wound Healing.

Bioengineering (Basel). 2021-5-11

[7]
Comparison of the efficacy of growth factor collagen and antibiotic collagen on colon anastomosis in  experimental animals with peritonitis.

Indian J Gastroenterol. 2021-6

[8]
How to Prevent Anastomotic Leak in Colorectal Surgery? A Systematic Review.

Ann Coloproctol. 2020-8

[9]
The Biology of Anastomotic Healing-the Unknown Overwhelms the Known.

J Gastrointest Surg. 2020-9

[10]
Mechanical strength of biliary defect closure after topical sealing: Comparison of four sealants in a porcine model.

Asian J Surg. 2018-12-29

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