Yang Song Soo, Kye Bong Hyeon, Kang Sang Hee, Kim Chang Hyun, Kim Ji Hoon, Kim Woo Ram, Lee Kil Yeon, Park In Kyu
Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Division of Colorectal Surgery, Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Ann Surg Treat Res. 2024 Aug;107(2):59-67. doi: 10.4174/astr.2024.107.2.59. Epub 2024 Jul 30.
We investigated the current practices and perceptions of colorectal surgeons in South Korea regarding intracorporeal ileocolic anastomosis (IIA) in minimally invasive right hemicolectomy (RHC).
Members of the Korean Society of Coloproctology (KSCP) participated in an online survey encompassing demographic information, surgical experiences, methods for IIA, and advantages, barriers, and perceptions of IIA. We performed a statistical analysis of survey results.
Among the 1,074 KSCP members contacted, 178 responded to the survey. Most respondents were males aged 40-49 years with >10 years of experience who were affiliated with a tertiary healthcare facility. One hundred fifty-six respondents had performed <100 colorectal cancer surgeries annually. Fifty-nine respondents reported experiences of the IIA technique in minimally invasive RHC. Most respondents favored the isoperistaltic side-to-side (S-S) anastomosis and stapled S-S anastomosis, hand-sewn closure for the common channel, and the periumbilical area for primary specimen extraction. Respondents with IIA experience emphasized the reduction in postoperative complications as the primary reason for performing IIA, whereas respondents without IIA experience cited the lack of benefits as the main deterrent. Respondents commonly cited concerns regarding anastomotic leakage and intraabdominal contamination as the primary reasons for not performing IIA. Respondents with IIA experience demonstrated a more positive response towards attempting or transitioning to IIA than those without. Respondents with IIA experience prioritized self-sufficiency, whereas respondents without IIA experience prioritized proctorship and discussions of the initial cases.
Measures to standardize the IIA technique and appropriate training programs must be implemented to enhance its use in minimally invasive RHC.
我们调查了韩国结直肠外科医生在微创右半结肠切除术(RHC)中进行体内回结肠吻合术(IIA)的当前实践和看法。
韩国结直肠外科学会(KSCP)的成员参与了一项在线调查,内容包括人口统计学信息、手术经验、IIA方法以及IIA的优势、障碍和看法。我们对调查结果进行了统计分析。
在联系的1074名KSCP成员中,178人回复了调查。大多数受访者为40 - 49岁的男性,有超过10年的经验,隶属于三级医疗机构。156名受访者每年进行的结直肠癌手术少于100例。59名受访者报告了在微创RHC中使用IIA技术的经验。大多数受访者倾向于采用顺蠕动侧侧(S - S)吻合术和吻合器辅助的S - S吻合术,手工缝合共同通道,并在脐周区域提取主要标本。有IIA经验的受访者强调减少术后并发症是进行IIA的主要原因,而没有IIA经验的受访者则认为缺乏益处是主要阻碍。受访者普遍提到对吻合口漏和腹腔内污染的担忧是不进行IIA的主要原因。有IIA经验的受访者对尝试或转向IIA的反应比没有经验的受访者更积极。有IIA经验的受访者优先考虑自我能力,而没有IIA经验的受访者则优先考虑有经验者指导和对初始病例的讨论。
必须采取措施规范IIA技术并实施适当的培训计划,以增加其在微创RHC中的应用。