Usefulness of intraoperative colonoscopy and synchronous scoring system for determining the integrity of the anastomosis in left-sided colectomy: a single-center retrospective cohort study.

IF 1.6 3区医学 Q2 SURGERY

BMC Surgery Pub Date : 2025-03-27 DOI:10.1186/s12893-025-02836-6

Sung Hwan Cho, Hyun Sung Kim, Byung-Soo Park, Gyung Mo Son, Su Bum Park, Mi Sook Yun

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引用次数: 0

Abstract

Objectives: The aim of this study is to evaluate the utilization of intraoperative colonoscopy (IOC) for determining the integrity of the anastomosis and to establish an IOC scoring system.

Methods: A retrospective cohort study was conducted from January 2021 to June 2024, we analyzed the clinical data of 160 patients registered in a database who underwent laparoscopic left-sided colectomy at Pusan National University Yangsan Hospital. IOC was performed on all patients, and Mucosal color (MC), stapled line bleeding (BL), proximal redundancy (PR), and bowel preparation (BP) were evaluated and scored as variables. Logistic regression analysis was used to evaluate risk factors for anastomotic leakage (AL) and Cohen's kappa was applied to assess the reproducibility of the evaluation.

Results: Of 160 patients, 10 (6.25%) experienced AL. All the IOC variables had kappa values of 0.8 or higher, indicating good agreement. The logistic regression analysis revealed significant differences in the MC 2 (P = 0.017, OR 12.86), PR 2 (P = 0.001, OR 27.64), BP 2 (p = 0.016, OR 10.50) PR 2 score (P = 0.016, OR 10.50) and the sum of the scores (p = 0.001, OR 3.51).

Conclusion: IOC can be performed as a reference procedure to assess the integrity of the anastomosis during left-sided colorectal surgery.

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术中结肠镜检查和同步评分系统对确定左侧结肠切除术吻合完整性的有效性：一项单中心回顾性队列研究。

目的：本研究的目的是评估术中结肠镜检查（IOC）在确定吻合完整性方面的应用，并建立IOC评分系统。方法：回顾性队列研究于2021年1月至2024年6月进行，我们分析了数据库中登记的160例在釜山国立大学梁山医院行腹腔镜左侧结肠切除术的患者的临床资料。对所有患者进行IOC，并将粘膜颜色（MC）、钉线出血（BL）、近端冗余（PR）和肠准备（BP）作为变量进行评估和评分。采用Logistic回归分析评价吻合口漏（AL）的危险因素，采用Cohen’s kappa评价评价的可重复性。结果：160例患者中，10例（6.25%）发生AL，所有IOC变量kappa值均在0.8及以上，一致性良好。logistic回归分析显示mc2 （P = 0.017, OR 12.86）、PR 2 （P = 0.001, OR 27.64）、BP 2 （P = 0.016, OR 10.50）、PR 2评分（P = 0.016, OR 10.50）和总分（P = 0.001, OR 3.51）差异均有统计学意义。结论：IOC可作为评价左侧结直肠手术吻合完整性的参考方法。

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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