[The Short-term Analysis of Overlapped Delta-shaped Anastomosis in Total Laparoscopic Transverse Colectomy]

Zhonghua Zhong Liu Za Zhi. 2019 Mar 23;41(3):188-192. doi: 10.3760/cma.j.issn.0253-3766.2019.03.007.
[Article in Chinese]

Abstract

Objective: The aim of this study was to explore the clinical safety, feasibility and short-term effect of overlapped delta-shaped anastomosis in total laparoscopic transverse colectomy. Methods: The records, which were based on China National Cancer Center, of 20 and 31 patients who underwent total laparoscopic transverse colectomy with overlapped delta-shaped anastomosis and laparoscopic-assisted transverse colectomy with conventional extracorporeal anastomosis, from March 2017 to May 2018 were reviewed retrospectively. Data regarding surgical outcomes, postoperative recovery, pathological outcomes and perioperative complications were collected and compared. Results: There was no difference between the two groups in overall operation time, anastomosis time and intraoperative blood loss (P>0.05), however, the length of incision was significantly shorter in overlapped delta-shaped group [(4.7±0.6) cm vs. (5.5±1.0) cm, P=0.002]. The time to ground activities, first flatus and postoperative hospitalization did not differ between the two groups (P>0.05). The postoperative visual analogue scale was lower in the overlapped delta-shaped group than the control group on postoperative day 1 (3.7±0.7 vs. 4.2±0.9, P=0.015) and postoperative day 3 (2.7±0.5 vs. 3.2±0.9, P=0.040). The perioperative complication rates were 10.0% and 12.9% in the overlapped delta-shaped group and the control group, respectively, and the difference was not significant (P=0.753). Conclusion: Compared to conventional extracorporeal anastomosis, total laparoscopic transverse colectomy with overlapped delta-shaped anastomosis was a safe and feasible procedure with satisfactory short-term effect, shorter incision and less postoperative pain.

目的: 探讨重叠三角吻合在完全腹腔镜横结肠癌根治术中应用的安全性、可行性和近期疗效。 方法: 回顾性分析中国医学科学院肿瘤医院2017年3月至2018年5月收治的51例横结肠癌患者的临床资料,其中行重叠三角吻合的完全腹腔镜横结肠切除术(重叠三角吻合组)20例,行常规体外吻合的腹腔镜辅助横结肠切除术(对照组)31例,对比两组患者的手术和术后恢复情况、病理情况以及围手术期并发症的发生情况等。 结果: 重叠三角吻合组和对照组患者的手术时间、吻合时间和术中出血量的差异均无统计学意义(均P>0.05),但重叠三角吻合组患者的切口长度为(4.7±0.6)cm,明显小于对照组[(5.5±1.0)cm,P=0.002]。重叠三角吻合组和对照组患者的下地时间、排气时间和住院时间的差异均无统计学意义(均P>0.05),但重叠三角吻合组患者的术后第1天和第3天疼痛视觉模拟评分分别为(3.7±0.7)分和(2.7±0.5)分,明显低于对照组患者的评分[分别为(4.2±0.9)分和(3.2±0.9)分,均P<0.05]。重叠三角吻合组和对照组患者的肿瘤大小、远近切缘距离、淋巴结清扫数目、肿瘤TNM分期的差异均无统计学意义(均P>0.05)。重叠三角吻合组和对照组患者围手术期并发症的发生率分别为10.0%(2/20)和12.9%(4/31),差异无统计学意义(P=0.753)。 结论: 应用重叠三角吻合的完全腹腔镜横结肠切除术切实可行,安全可靠,且切口长度更短,疼痛更轻,具有满意的近期疗效。.

Keywords: Colectomy; Colonic neoplasms; Digestive tract reconstruction; Overlapped delta-shaped anastomosis; Total laparoscopic surgery.

MeSH terms

  • Anastomosis, Surgical / methods
  • China
  • Colectomy / methods*
  • Feasibility Studies
  • Humans
  • Laparoscopy*
  • Length of Stay
  • Operative Time
  • Pain Measurement
  • Postoperative Complications
  • Retrospective Studies
  • Treatment Outcome