A case-control study of extracorporeal versus intracorporeal anastomosis in patients subjected to right laparoscopic hemicolectomy
A case-control study of extracorporeal versus intracorporeal anastomosis in patients subjected to right laparoscopic hemicolectomy
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DOI：
10.1016/j.ciresp.2010.10.003
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发表时间：
2011-01-01
期刊：
影响因子：
1.9
通讯作者：
Hernandez Lizoain, Jose Luis
中科院分区：
文献类型：
--
作者：
Arredondo Chaves, Jorge;Pastor Idoate, Carlos;Hernandez Lizoain, Jose Luis
简介：关于哪种技术是在右半结肠腹腔镜切除术中进行吻合术的最佳技术（腹腔内（IC）或体外（EC）），仍缺乏足够的科学证据。本研究的目的是确定是否有差异，比较在这两种technology.Material和Methods：一项研究进行了前瞻性的患者系列在我们的医院接受右腹腔镜半结肠切除术。术前和术后的变量与并发症的记录取决于类型的astonish.Results：共60例患者进行了干预，从2004年6月至2010年6月（35 IC; 25 EC）。两组之间在基线术前特征或相关合并症方面无显著差异。中位手术时间为212分钟（142-305分钟），两种技术之间没有显着差异。IC组中切除的淋巴结数量较高（21 vs 14; p = 0.03）。IC组的口服耐受开始和首次排便明显更早。两组的并发症发生率相似（IC 14%; EC 16%; p = 0.89）。IC组中有3例患者发生吻合口裂开。结论：腹腔镜右半结肠切除术中肠内吻合与肠外吻合相比，可获得更高的淋巴结切除量，更早的经口耐受和肠道转运。(C)2010年AEC。出版社：Elsevier Espana，S.L. All rights reserved.
Introduction: There is still insufficient scientific evidence on which is the best technique to perform the anastomosis -intracorporeal (IC) or extracorporeal (EC)- in right laparoscopic hemicolectomy. The objective of the present study is to determine whether there are differences to compare in both techniques.Material and methods: A study was performed on a prospective patient series subjected to right laparoscopic hemicolectomy in our Hospital. The preoperative and the postoperative variables associated with complications recorded depending on the type of anastomosis.Results: A total of 60 patients were intervened form June 2004 to June 2010 (35 IC; 25 EC). There were no significant differences between both groups as regards baseline preoperative characteristics or associated comorbidities. The median operation time was 212 minutes (142-305 min), with no significant difference between both techniques. The number of lymph nodes removed was higher in the IC group (21 versus 14; p = 0.03). The beginning of oral tolerance and the first bowel movement were significantly earlier in the IC group. The complications rate was similar for both groups (14% IC; 16% EC; p = 0.89). Three patients in the IC group had anastomosis dehiscence. The mortality rate was 2.8% (one patient in each group).Conclusion: Intracorporeal versus extracorporeal anastomosis in right laparoscopic hemicolectomy can obtain a higher number of resected lymph nodes and an earlier oral tolerance and intestinal transit. (C) 2010 AEC. Published by Elsevier Espana, S.L. All rights reserved.