Department of Colorectal Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.
Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, P. R. China.
Langenbecks Arch Surg. 2024 Oct 12;409(1):305. doi: 10.1007/s00423-024-03494-7.
This study aimed to investigate the effectiveness of a novel method for anastomosis reinforcement to minimize the occurrence of anastomotic complications after surgical resection of rectal and sigmoid cancer.
We recruited 378 patients who underwent laparoscopic rectal anterior resection of rectal cancer and sigmoid cancer in SYSUCC. The occurrence rates of intraoperative bleeding, operation time, and postoperative anastomotic complications were compared between the treatment group receiving anastomotic reinforcement and the control group without anastomotic reinforcement.
The incidence of anastomotic leakage in the treatment group was significantly lower than that in the control group (1.59% vs. 11.64%, p < 0.001). Following the application of inverse probability of treatment weighting (IPTW) to adjust for factors influencing the occurrence of anastomotic leakage, the incidence of anastomotic leakage remained significantly lower in the treatment group compared to the control group (2.54% vs. 12.08%, p < 0.001).
The circumferential continuous anastomosis reinforcing suture method, recommended for laparoscopic surgery for rectal and sigmoid cancer, has the potential to effectively minimize the occurrence of anastomotic complications.
本研究旨在探讨一种新型吻合加固方法，以最大限度地减少直肠癌和乙状结肠癌手术后吻合口并发症的发生。
我们招募了 378 名在中山大学附属第六医院接受腹腔镜直肠前切除术的直肠癌和乙状结肠癌患者。比较接受吻合加固治疗的治疗组和未接受吻合加固治疗的对照组之间术中出血、手术时间和术后吻合口并发症的发生率。
治疗组吻合口漏的发生率明显低于对照组（1.59%比 11.64%，p<0.001）。应用逆概率治疗加权（IPTW）调整影响吻合口漏发生的因素后，治疗组吻合口漏的发生率仍明显低于对照组（2.54%比 12.08%，p<0.001）。
对于腹腔镜下直肠和乙状结肠癌手术，推荐使用环形连续吻合加固缝合方法，有可能有效减少吻合口并发症的发生。
