Incidence of and risk factors for anastomotic leakage after laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis for rectal cancer
Incidence of and risk factors for anastomotic leakage after laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis for rectal cancer
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DOI：
10.1016/j.amjsurg.2010.11.014
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发表时间：
2011-09-01
影响因子：
3
通讯作者：
Yamaguchi, Toshiharu
中科院分区：
文献类型：
--
作者：
Akiyoshi, Takashi;Ueno, Masashi;Yamaguchi, Toshiharu
背景：腹腔镜直肠癌手术涉及直肠内吻合器械的直肠分割，在技术上存在困难。本研究旨在确定与腹腔镜直肠癌前切除术相关的吻合口瘘的危险因素。方法：我们研究了363例在2005年7月至2010年2月期间接受腹腔镜直肠癌前切除术联合直肠内横断和双吻合器技术（DST）吻合的患者。22个独立的临床变量进行了单变量和多变量分析。结果：吻合口瘘13例（3.6%）。多变量分析确定中/低位直肠癌（比值比，9.446）和缺乏盆腔引流（比值比，3.814）是吻合口瘘的独立预测因素。用于直肠分裂的墨盒的数量没有显着的影响，吻合口leakage.CONCLUSIONS：腹腔镜前切除术，涉及直肠内横断和DST吻合术是安全的，如果使用适当的技术进行。(C)2011 Elsevier Inc. All rights reserved.
BACKGROUND: Laparoscopic rectal cancer surgery involving rectal division with intracorporeal stapling devices is technically difficult. This study aimed to identify risk factors for anastomotic leakage associated with laparoscopic anterior resection for rectal cancer.METHODS: We studied 363 patients who underwent laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique (DST) anastomosis for rectal cancer between July 2005 and February 2010. Twenty-two independent clinical variables were examined by univariate and multivariate analyses. The outcome of interest was clinical anastomotic leakage.RESULTS: Anastomotic leakage was identified in 13 (3.6%) patients. Multivariate analysis identified middle/lower rectal cancer (odds ratio, 9.446) and lack of pelvic drain (odds ratio, 3.814) as independent predictive factors for anastomotic leakage. The number of cartridges used for rectal division had no significant impact on anastomotic leakage.CONCLUSIONS: Laparoscopic anterior resection involving intracorporeal rectal transection and DST anastomosis is safe if performed using an appropriate technique. (C) 2011 Elsevier Inc. All rights reserved.