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“端-角”吻合在腹腔镜下直肠低位双吻合中的应用及效果观察 被引量:3

Laparoscopic "end-corner" anastomosis in double.stapling technique for mid-low rectal cancer resection
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摘要 目的 观察一种改良直肠低位双吻合的临床效果,探讨其临床价值.方法 回顾性分析2011年2月至2015年2月在苏州大学附属第一医院完成腹腔镜下直肠低位前切除术的患者临床资料.根据直肠低位双吻合的操作方法不同,分为改良组(51例)和常规组(74例),对比分析两组患者的一般资料、病理学检查结果、围手术期临床资料.应用SPSS 17.0进行统计学分析,计量资料采用£检验,计数资料采用x2检验.结果 两组患者一般资料差异无统计学意义(P>0.05).改良组手术时间多于常规组[(169±23)比(150±42) min,t=-3.150,P<0.05],而引流管留置天数[(7.9±2.9)比(10.8±11.6)d,t=1.999,P<0.05]和术后住院天数[(10.0±3.6)d比(13.3±13.7)d,t=1.025,P<0.05]短于常规组;改良组吻合口瘘的发生率(2.0%比18.9%,x2=4.402,P<0.05)以及里急后重感的发生率(3.9%比17.6%,x2 =4.110,P<0.05)低于常规组.两组患者术中出血量、排气时间、进食流质饮食时间、拔导尿管时间、吻合口出血、肠梗阻、再次手术造口以及术后感染差异无统计学意义.结论 与常规的腹腔镜下直肠低位前切除术相比,“端-角”吻合降低了术后吻合口瘘及“直肠低位前切除综合征”的发生率. Objective To observe clinical efficacy and explore clinical value of a modified procedure of double-stapling technique for mid-low rectal cancer.Methods Clinical data of patients undergoing laparoscopic anterior resection at the Department of General Surgery,the First Affiliated Hospital of Soochow University from February 2011 to February 2015 was analyzed retrospectively.According to the different ways in doing double-stapling technique,we divided patients into modified group (51 cases) and conventional group (74 cases).Parameters were compared between the two groups as general considerations,oncologic outcomes.Data were analyzed by SPSS 17.0 software packet,using t and x2 inspection.Results The difference of the general data of two groups was not statistically significant (P 〉 0.05).Operation time in the modified group was longer than that of the conventional group [(169 ± 23) vs.(150 ±42)min,t =-3.150,P 〈0.05],but it had shorter drainage tube indwelling days [(7.9 ±2.9)d vs.(10.8±11.6)d,t=1.999,P〈0.05] and length of hospital stay after surgery [(10.0±3.6)d vs.(13.3 ± 13.7) d,t =1.025,P 〈 0.05].The incidence of anastomotic leakage (2.0% vs.18.9%,x2 =4.402,P 〈 0.05) and tenesmus(3.9% vs.17.6%,x2 =4.110,P 〈 0.05) in the modified group was less than that of the conventional group.The difference in those areas was not statistically significant (P 〉 0.05),such as intraopretive blood loss,per-anal exhaust time,consumption of liquid diet time,anastomotic bleeding,intestinal obstruction,reoperation for neostomy and infections.Conclusions Compared with traditional laparoscopic anterior resection,"End-Corner" anastomosis has the benefits of less postoperative anastomotic leakage and fewer" low anterior resection syndrome".
作者 韩善亮 陈少骥 莫秦良 马远明 宋世铎 赵宏 Han Shanliang, Chen Shaoji, Mo Qinliang, Ma Yuanming, Song Shiduo, Zhao Hong ( Department of General Surgery, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China)
出处 《中华普通外科杂志》 CSCD 北大核心 2016年第2期108-112,共5页 Chinese Journal of General Surgery
关键词 直肠肿瘤 腹腔镜 结直肠外科手术 手术后并发症 Rectal neoplasms Laparoscopes Colorectal surgery Postoperative complications
作者简介 通信作者:陈少骥,E-mail:20125232078@suda.edu.cn
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  • 1Ziv Y, Zbar A, Bar-Shavit Y, ct al. Low anterior resection syndrome ( LARS ) : cause and effect and reconstructive considerations [ J ]. Tech Coloproctol, 2013,17 ( 2 ) : 151 - 162. 被引量:1
  • 2Akiyoshi T,Fukunaga Y,Fujimoto Y,et al. Incidence of and risk factors for anastomotie leakage after laparoseopic anterior resection with intracorporeal rectal transection and double- stapling technique anastomosis for rectal cancer [ J ]. The American Journal Surgery, 2011,202 ( 3 ) : 259-264. 被引量:1
  • 3Majbar MA, Ehualki HO, Souadka A, et al. Risk factors for anastomotic leakage after anterior resection for reetal adenocarcinoala [ J ]. LA Tunisie Medieale, 2014, 92 ( 7 ) : 493 -496. 被引量:1
  • 4Kim CW,Baek SJ, Hur H, et al. Anaslomotic leakage after low anterior resection for rectal cancer is different between minimally invasive surgery and open surgery[ J]. Ann Surg,2015,260( 1 ): 1-7. 被引量:1
  • 5Lee DS, Ryu JA, Chung CR, et al. Risk factors for acquisition of multidrug resistant bacteria in patients with anastomotic leakage after colorectal cancer surgery [ J]. lnt J Colorectal Dis,2015,30 (4) :497-504. 被引量:1
  • 6Roumen RM, Rahusen FT, Wijnen MH, et al. " Dog ear" formation after double-stapled low anterior resection as a risk factor for anastomotic disruption [ J ]. Dis Colon Rectum,2000,43 (4) :522-525. 被引量:1
  • 7Baek SJ ,Kim J, Kwak J, et al. Can trans-anal reinforcing sutures after double stapling in lower anterior resection reduce the need for a temporary diverting ostomy? [ J ]. World J Gastroenteml, 2013,28(32) :5309-5313. 被引量:1
  • 8Kang J, Lee HB, Cha JH, et al. Feasibility and impact on surgical outcomes of modified double-stapling technique for patients undergoing laparoscopic anterior resection [ J ]. J Gastrointest Surg,2013,17(4) :771-775. 被引量:1
  • 9Kim HJ, Choi GS, Park JS, et al. Comparison of intracorporeal single-stapled and double- stapled anastomosis in laparoscopic low anterior resection for rectal cancer: a ease-control study [ J ], Int J Colorectal Dis,2013,28( 1 ) : 149-156. 被引量:1
  • 10Romaniszyn M, Richter P, Walega P, et al. Low-anterior-resection syndrome. How does neoadjuvant radiotherapy and low resection of the rectum influence the function of anal sphincters in patients with rectal cancer? Preliminary results of a functional assessment study[J]. Polskl Przeglad Chirurgiczny,2012,84(4) :177-183. 被引量:1

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