腹腔镜下中低位直肠癌根治术中吻合口加固缝合预防术后吻合口瘘的效果及对术后恢复的影响

Effect of anastomotic reinforcement and suture on prevention of postoperative anastomotic leakage in laparoscopic radical resection of middle and low rectal cancer and its influence on postoperative recovery

目的:探究腹腔镜直肠癌根治术中吻合口加固缝合对中低位直肠癌患者术后吻合口瘘的预防效果及对术后恢复的影响。方法:收集2018年01月至2021年06月在我院诊断为直肠癌且肿瘤距离肛门10 cm以内,行腹腔镜下直肠癌前切除术患者,详细收集患者临床资料,比较加固缝合组患者与传统吻合组患者术后相关临床指标的差异。结果:本研究共纳入254例患者,两组患者在一般指标对比上均未见明显差异。加固缝合组患者手术时间较传统吻合组明显增加(P<0.05);而两组患者在术中出血量、术后排气排便时间、术后吻合口瘘发生情况及时间上并无统计学差异(P>0.05)。结论:腹腔镜下加固缝合中低位直肠癌吻合口对于预防术后吻合口瘘的发生效果仍不确切,需大量研究进一步证实。

Objective:To explore the effect of reinforcement suture during laparoscopic radical resection of rectal cancer on the prevention of postoperative anastomotic leakage and its influence on postoperative recovery.Methods:We respectively collected patients who were diagnosed with rectal cancer in our hospital from January 2018 to June 2021 and the tumor was within 10 cm of the anus,and underwent laparoscopic precancerous resection of the rectum.The clinical data of the patients were collected in detail.Then we compared the clinical data between the reinforced anastomosis group were compared with the traditional ones.Results:A total of 254 patients were included in this study,and there was no obvious abnormality in the comparison of general indicators between the two groups.The operation time of patients in the reinforced suture group was significantly longer than that in the traditional suture group(P<0.05).However,there was no statistical difference between the two groups of patients in terms of intraoperative blood loss,postoperative exhaust and defecation time,postoperative anastomotic leakage incidence and time(P>0.05).Conclusion:The effect of laparoscopic reinforced suture of middle and low rectal cancer anastomosis in preventing postoperative anastomotic leakage is still inaccurate,and a large number of studies are still needed to confirm it.