兩種機械吻合方式在腹腔鏡輔助右半結腸癌術中的回顧性對照研究_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

程康文 ,  王貴和 , 束寬山 , 鄭明 , 劉紅霞 , 馬冬花

銅陵市人民醫院胃腸外科（安徽銅陵 244000）;

Corresponding?author：

王貴和, Email: yiyuanckw@163.com

Keywords：

結腸腫瘤; 腹腔鏡; 結腸切除術; 吻合術

DOI：

10.7507/1007-9424.201902031

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的比較體外機械性側側吻合與端側吻合在腹腔鏡輔助右半結腸癌根治術中的應用效果。方法回顧性分析筆者所在醫院 2015 年 6 月至 2018 年 6 月期間采用機械吻合進行消化道重建的 89 例腹腔鏡輔助右半結腸癌根治術患者的臨床資料，其中機械性側側吻合 32 例，機械性端側吻合 57 例；比較 2 組患者的一般資料、手術時間、術中出血量、術后首次肛門排氣時間、耐受流質飲食時間和術后住院時間；并比較術后并發癥發生情況。結果 2 組患者的一般資料、術中出血量、耐受流質飲食時間和術后住院時間的差異均無統計學意義（P>0.05）；端側吻合組手術時間短于側側吻合組［160.0（150.0，177.5） min 比 170.0（156.3，203.8）min］，差異有統計學意義（P=0.049）；端側吻合組首次肛門排氣時間短于側側吻合組［（2.5±0.9）d 比（3.0±1.0）d］，差異有統計學意義（P=0.021）；2 組患者術后各并發癥發生率差異無統計學意義（P>0.05）。結論腹腔鏡輔助右半結腸癌根治性切除手術中相比機械性側側吻合，機械性端側吻合的手術時間及術后首次肛門通氣時間較短，其并發癥無統計學差異，提示機械性端側吻合可能更具優勢。

Citation： 程康文, 王貴和, 束寬山, 鄭明, 劉紅霞, 馬冬花. 兩種機械吻合方式在腹腔鏡輔助右半結腸癌術中的回顧性對照研究. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(7): 856-860. doi: 10.7507/1007-9424.201902031 Copy

1.	Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol, 2009, 10(1): 44-52.
2.	Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet, 2005, 365(9472): 1718-1726.
3.	Simillis C, Purkayastha S, Yamamoto T, et al. A meta-analysis comparing conventional end-to-end anastomosis vs. other anastomotic configurations after resection in Crohn’s disease. Dis Colon Rectum, 2007, 50(10): 1674-1687.
4.	Cirocchi R, Trastulli S, Farinella E, et al. Intracorporeal versus extracorporeal anastomosis during laparoscopic right hemicolectomy—systematic review and meta-analysis. Surg Oncol, 2013, 22(1): 1-13.
5.	Puleo S, Sofia M, Trovato MA, et al. Ileocolonic anastomosis: preferred techniques in 999 patients. A multicentric study. Surg Today, 2013, 43(10): 1145-1149.
6.	Liu Z, Wang G, Yang M, et al. Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side? World J Surg Oncol, 2014, 12: 306.
7.	Lee KH, Lee SM, Oh HK, et al. Comparison of anastomotic configuration after laparoscopic right hemicolectomy under enhanced recovery program: side-to-side versus end-to-side anastomosis. Surg Endosc, 2016, 30(5): 1952-1957.
8.	Offodile AC 2nd, Feingold DL, Nasar A, et al. High incidence of technical errors involving the EEA circular stapler: a single institution experience. J Am Coll Surg, 2010, 210(3): 331-335.
9.	李新峰, 侯臣芳. 腹腔鏡結腸癌根治術與開腹結腸癌根治術的近、遠期療效對比. 現代腫瘤醫學, 2017, 25(4): 584-587.
10.	李繼勇. 腹腔鏡和開腹右半結腸癌根治術臨床對比分析. 臨床外科雜志, 2017, 25(9): 685-687.
11.	Hohenberger W, Weber K, Matzel K, et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation-technical notes and outcome. Colorectal Dis, 2009, 11(4): 354-364.
12.	Oh HK, Ihn MH, Son IT, et al. Factors associated with failure of enhanced recovery programs after laparoscopic colon cancer surgery: a single-center retrospective study. Surg Endosc, 2016, 30(3): 1086-1093.
13.	Smith TK, Robertson WJ. Synchronous movements of the longitudinal and circular muscle during peristalsis in the isolated guinea-pig distal colon. J Physiol, 1998, 506(Pt 2): 563-577.
14.	Moon SB, Park KJ, Moon JS, et al. Migrating motor complex changes after side-to-side ileal bypass in mouse ileum ex vivo: mechanism underlying the blind loop syndrome? J Korean Surg Soc, 2011, 80(4): 251-259.
15.	Mu?oz-Juárez M, Yamamoto T, Wolff BG, et al. Wide-lumen stapled anastomosis vs. conventional end-to-end anastomosis in the treatment of Crohn’s disease. Dis Colon Rectum, 2001, 44(1): 20-25.
16.	俞旻皓, 祁洋, 秦紹嵐, 等. 腹腔鏡與開腹右半結腸癌全結腸系膜切除術的回顧性臨床對照研究. 外科理論與實踐, 2018, 23(2): 145-149.
17.	李建. 腹腔鏡右半結腸癌 CME 手術臨床效果分析. 中華普外科手術學雜志 (電子版), 2017, 11(2): 111-113.
18.	李方琨, 陳修濤, 謝慧臣. 不同吻合方式在腹腔鏡輔助右半結腸切除術中的療效比較. 腹腔鏡外科雜志, 2018, 23(10): 782-785.
19.	Resegotti A, Astegiano M, Farina EC, et al. Side-to-side stapled anastomosis strongly reduces anastomotic leakage rates in Crohn’s disease surgery. Dis Colon Rectum, 2005, 48(3): 464-468.

1. Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol, 2009, 10(1): 44-52.
2. Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet, 2005, 365(9472): 1718-1726.
3. Simillis C, Purkayastha S, Yamamoto T, et al. A meta-analysis comparing conventional end-to-end anastomosis vs. other anastomotic configurations after resection in Crohn’s disease. Dis Colon Rectum, 2007, 50(10): 1674-1687.
4. Cirocchi R, Trastulli S, Farinella E, et al. Intracorporeal versus extracorporeal anastomosis during laparoscopic right hemicolectomy—systematic review and meta-analysis. Surg Oncol, 2013, 22(1): 1-13.
5. Puleo S, Sofia M, Trovato MA, et al. Ileocolonic anastomosis: preferred techniques in 999 patients. A multicentric study. Surg Today, 2013, 43(10): 1145-1149.
6. Liu Z, Wang G, Yang M, et al. Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side? World J Surg Oncol, 2014, 12: 306.
7. Lee KH, Lee SM, Oh HK, et al. Comparison of anastomotic configuration after laparoscopic right hemicolectomy under enhanced recovery program: side-to-side versus end-to-side anastomosis. Surg Endosc, 2016, 30(5): 1952-1957.
8. Offodile AC 2nd, Feingold DL, Nasar A, et al. High incidence of technical errors involving the EEA circular stapler: a single institution experience. J Am Coll Surg, 2010, 210(3): 331-335.
9. 李新峰, 侯臣芳. 腹腔鏡結腸癌根治術與開腹結腸癌根治術的近、遠期療效對比. 現代腫瘤醫學, 2017, 25(4): 584-587.
10. 李繼勇. 腹腔鏡和開腹右半結腸癌根治術臨床對比分析. 臨床外科雜志, 2017, 25(9): 685-687.
11. Hohenberger W, Weber K, Matzel K, et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation-technical notes and outcome. Colorectal Dis, 2009, 11(4): 354-364.
12. Oh HK, Ihn MH, Son IT, et al. Factors associated with failure of enhanced recovery programs after laparoscopic colon cancer surgery: a single-center retrospective study. Surg Endosc, 2016, 30(3): 1086-1093.
13. Smith TK, Robertson WJ. Synchronous movements of the longitudinal and circular muscle during peristalsis in the isolated guinea-pig distal colon. J Physiol, 1998, 506(Pt 2): 563-577.
14. Moon SB, Park KJ, Moon JS, et al. Migrating motor complex changes after side-to-side ileal bypass in mouse ileum ex vivo: mechanism underlying the blind loop syndrome? J Korean Surg Soc, 2011, 80(4): 251-259.
15. Mu?oz-Juárez M, Yamamoto T, Wolff BG, et al. Wide-lumen stapled anastomosis vs. conventional end-to-end anastomosis in the treatment of Crohn’s disease. Dis Colon Rectum, 2001, 44(1): 20-25.
16. 俞旻皓, 祁洋, 秦紹嵐, 等. 腹腔鏡與開腹右半結腸癌全結腸系膜切除術的回顧性臨床對照研究. 外科理論與實踐, 2018, 23(2): 145-149.
17. 李建. 腹腔鏡右半結腸癌 CME 手術臨床效果分析. 中華普外科手術學雜志 (電子版), 2017, 11(2): 111-113.
18. 李方琨, 陳修濤, 謝慧臣. 不同吻合方式在腹腔鏡輔助右半結腸切除術中的療效比較. 腹腔鏡外科雜志, 2018, 23(10): 782-785.
19. Resegotti A, Astegiano M, Farina EC, et al. Side-to-side stapled anastomosis strongly reduces anastomotic leakage rates in Crohn’s disease surgery. Dis Colon Rectum, 2005, 48(3): 464-468.

Previous Article
Part Ⅱ of database building: tag and structure of hospitalization process management of colorectal cancer
Next Article
覆膜支架治療難治性股動脈假性動脈瘤的探討

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

兩種機械吻合方式在腹腔鏡輔助右半結腸癌術中的回顧性對照研究

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content