使用线性订书机用于结肠癌的三角形吻合术与功能性端到端吻合的短期结局
Short-term outcomes of delta-shaped anastomosis versus functional end-to-end anastomosis using linear staplers for colon cancer
影响因子:2.90000
分区:医学3区 / 胃肠肝病学3区 外科3区
发表日期:2024 Sep 23
作者:
R Ono, T Tominaga, M Ishii, M Hisanaga, M Araki, Y Sumida, T Nonaka, S Hashimoto, T Shiraishi, K Noda, H Takeshita, H Fukuoka, S Oyama, K Ishimaru, T Sawai, K Matsumoto
摘要
几种方法用于结肠癌手术中的重建，包括手缝或吻合吻合。但是，很少有报道比较重建方法之间的短期结局。这项研究比较了三角洲形的吻合术（Delta）和功能性端到端吻合术（FEEA）之间的短期结局。我们回顾性地回顾了1314例连续接受结直肠手术的患者，并在2016年1月至2023年1月之间进行了FEEA或三角洲重建的结肠直肠手术。 n = 72）。应用倾向评分匹配以最大程度地减少选择偏差的可能性，并平衡可能影响术后并发症的协变量。比较了小组之间的短期结局。验证并发症发生在F组的215例患者中（17.3％），D组为8例（11.1％）。 Before matching, transverse colon cancer was more frequent (p = 0.002), clinical N-positive status was less frequent (44.1% versus 16.7%, p < 0.001), distant metastasis was less frequent (11.7% versus 1.4%, p = 0.003), and laparoscopic approach was more frequent (87.8% versus 100%, p < 0.001) in D group.匹配后，两组之间没有明显的任何临床因素差异。 D组中的失血量显着降低（28 mL vs 10 mL，P = 0.002），但是组之间的操作时间和术后并发症率相似。DELTA和FEEA都被认为是安全的，因为重建方法是安全的。需要进一步的研究来阐明Delta和FEEA的适当案例选择。
Abstract
Several methods are used for reconstruction in colon cancer surgery, including hand-sewn or stapled anastomosis. However, few reports have compared short-term outcomes among reconstruction methods. This study compared short-term outcomes between delta-shaped anastomosis (Delta) and functional end-to-end anastomosis (FEEA).We retrospectively reviewed 1314 consecutive patients who underwent colorectal surgery with FEEA or Delta reconstruction between January 2016 and December 2023. Patients were divided into two groups according to reconstruction by FEEA (F group; n = 1242) or Delta (D group; n = 72). Propensity score matching was applied to minimize the possibility of selection bias and to balance covariates that could affect postoperative complications. Short-term outcomes were compared between groups.Postoperative complications occurred in 215 patients (17.3%) in F group and 8 patients (11.1%) in D group. Before matching, transverse colon cancer was more frequent (p = 0.002), clinical N-positive status was less frequent (44.1% versus 16.7%, p < 0.001), distant metastasis was less frequent (11.7% versus 1.4%, p = 0.003), and laparoscopic approach was more frequent (87.8% versus 100%, p < 0.001) in D group. After matching, no differences in any clinical factor were evident between groups. Blood loss was significantly lower (28 mL versus 10 mL, p = 0.002) in D group, but operation time and postoperative complication rates were similar between groups.Delta and FEEA were both considered safe as reconstruction methods. Further studies are needed to clarify appropriate case selection for Delta and FEEA.