微创经会阴腹会阴联合切除术在克罗恩病中的临床影响：一项回顾性分析
Clinical Impacts of Minimally Invasive Transperineal Abdominoperineal Resection in Crohn's Disease: A Retrospective Analysis.
作者信息
Kondo Yoshitaka, Kanaya Nobuhiko, Shoji Ryohei, Inokuchi Toshihiro, Hiraoka Sakiko, Yoshida Yusuke, Matsumi Yuki, Shigeyasu Kunitoshi, Teraishi Fuminori, Kuroda Shinji, Fujiwara Toshiyoshi
机构信息
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Research Center for Intestinal Health Science, Okayama University, Okayama, Japan.
出版信息
Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70149. doi: 10.1111/ases.70149.
INTRODUCTION
Crohn's disease (CD) often leads to complex anorectal complications, posing significant challenges in surgical management. Transperineal abdominoperineal resection (TpAPR) has emerged as a minimally invasive alternative to APR. This study aims to evaluate the safety and efficacy of TpAPR compared to APR in patients with CD.
METHODS
A retrospective analysis was conducted on 19 CD patients who underwent either minimally invasive TpAPR (n = 11) or APR (n = 8) between 2008 and 2023 from a single institution. The primary outcomes were assessed: intraoperative blood loss, operative time, and surgical site infection (SSI) rates.
RESULTS
The minimally invasive TpAPR group exhibited significantly reduced intraoperative blood loss (223 mL vs. 533 mL, p = 0.04) and a lower incidence of SSI rates (36.4% vs. 75%, p = 0.07). Operative time and hospital stay were comparable between groups.
CONCLUSION
Minimally invasive TpAPR demonstrates potential benefits over APR in reducing blood loss and SSI rates in CD patients. Further large-scale studies are warranted to confirm these findings.
引言
克罗恩病（CD）常导致复杂的肛肠并发症，给手术治疗带来重大挑战。经会阴腹会阴联合切除术（TpAPR）已成为腹会阴联合切除术（APR）的一种微创替代方法。本研究旨在评估TpAPR与APR相比在CD患者中的安全性和有效性。
方法
对2008年至2023年期间在单一机构接受微创TpAPR（n = 11）或APR（n = 8）的19例CD患者进行回顾性分析。评估主要结局：术中失血量、手术时间和手术部位感染（SSI）率。
结果
微创TpAPR组术中失血量显著减少（223 mL对533 mL，p = 0.04），SSI发生率较低（36.4%对75%，p = 0.07）。两组之间的手术时间和住院时间相当。
结论
微创TpAPR在减少CD患者的失血量和SSI率方面显示出优于APR的潜在益处。需要进一步的大规模研究来证实这些发现。
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