Effect of the First Assistant on Anastomotic Leakage after Rectal Cancer Surgery with Double-Stapling Anastomosis: A Propensity Score Matching Analysis.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2022-01-01 DOI:10.1159/000525909

Soo Young Lee, Sola Lee, Ook Song, Jaram Lee, Hyeong-Min Park, Chang Hyun Kim, Hyeong Rok Kim

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引用次数: 0

Abstract

Introduction: Proper handling and firing of the circular stapler are important for secure anastomosis in rectal cancer surgery. This study aimed to investigate the association between the first assistant and anastomotic leakage (AL) after rectal cancer surgery with double-stapling anastomosis.

Methods: Patients with primary rectal cancer who underwent low anterior resection with double-stapling anastomosis between January 2015 and September 2019 were included. Data on clinicopathological characteristics, including the first assistant's sex and experience level, were retrospectively reviewed, and the risk factors for AL were analyzed using propensity score matching analysis.

Results: Among 758 rectal cancer surgeries, residents participated in 401 (52.9%) surgeries, and fellows participated in 357 (47.1%) surgeries as first assistants. After propensity score matching (n = 650), AL occurred in 5.4% (35/650). The first assistant's experience level (resident: 5.5% vs. fellow: 5.2%, p = 0.862) and sex (male: 5.4% vs. female: 4.9%, p = 0.849) were not associated with the occurrence of AL. Male sex in patients was the only significant predictive factor for AL (odds ratio = 2.804, 95% confidence interval 1.070-7.351, p = 0.036).

Discussion/conclusion: The first assistant's sex and experience level were not associated with AL after rectal cancer surgery with double-stapling anastomosis. These findings may justify resident participation in rectal cancer surgeries in which circular staplers are used.

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第一辅助对直肠癌双吻合器吻合术后吻合口漏的影响:倾向评分匹配分析。

导读:在直肠癌手术中，环形吻合器的正确使用和发射是保证吻合安全的重要因素。本研究旨在探讨直肠癌双吻合器术后第一辅助与吻合口漏(AL)的关系。方法:选取2015年1月至2019年9月行双吻合器低位前切除术的原发性直肠癌患者。回顾性回顾临床病理特征数据，包括第一助理的性别和经验水平，并使用倾向评分匹配分析分析AL的危险因素。结果:758例直肠癌手术中，住院医师以第一助理的身份参与401例(52.9%)，研究员以第一助理的身份参与357例(47.1%)。倾向评分匹配(n = 650)后，AL发生率为5.4%(35/650)。第一助理的经验水平(住院医师:5.5%对同行:5.2%，p = 0.862)和性别(男性:5.4%对女性:4.9%，p = 0.849)与AL的发生无关，患者的男性是AL发生的唯一显著预测因素(优势比= 2.804,95%可信区间1.070 ~ 7.351,p = 0.036)。讨论/结论:直肠癌双吻合器术后第一助理的性别和经验水平与AL无关。这些发现可能证明居民参与使用圆形订书机的直肠癌手术是合理的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.