A comparison study of two fecal diversion methods based on novel intestinal stents for preventing anastomotic leakage after middle and lower rectal cancer surgery.

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery Pub Date : 2025-10-06 DOI:10.1186/s12893-025-03201-3

Dayong Wei, Xiong Zhou, Lian Bai, Jia Liu

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Abstract

Background: This study aims to evaluate the feasibility and safety of two intestinal fecal diversion methods using novel stents to prevent anastomotic leakage after surgery for middle and lower rectal cancer, and to compare their advantages and disadvantages for clinical application.

Methods: A retrospective analysis was conducted on 101 patients who underwent laparoscopic radical resection(LAR) for rectal cancer at Yongchuan Hospital from June 2021 to March 2024. Patients were divided into three groups: 26 in the ileum group (using terminal ileal stents) ,54 in the in situ group (using rectal in situ covered stents) and 21 in the control group. Preoperative, surgical, and postoperative data were compared among the three groups.

Results: No significant differences were found in baseline characteristics, surgical data, or the occurrence of postoperative anastomotic leakage or other complications. The in situ group showed no statistically significant differences from the control group in the postoperative hospital stay(12.6 ± 3.7 vs. 11.4 ± 2.9days, p > 0.05 ), total cost of hospitalization (48903.58 ± 7094.14 vs. 82205.77 ± 12222.41yuan, p > 0.05). Moreover, the ileum group in these comparisons performed worse than the control group. After incorporating data related to stoma closure surgery, the in situ group and ileum group showed significant advantages in overall hospitalization costs(59085.88 ± 7460.79 vs. 48903.58 ± 7094.14 vs. 81418.32 ± 11186.78yuan, p < 0.05), and the in-situ group also had shorter overall hospital stay(17.6 ± 5.0 vs. 22.2 ± 4.0days, p < 0.05).

Conclusions: Both fecal diversion methods showed acceptable rates of postoperative anastomotic leakage and can avoid a second stoma closure surgery. The in situ covered stent method seemed better as it not only saved hospitalization time and costs but also made postoperative management simpler and more efficient.

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基于新型肠支架的两种粪便分流方法预防中、下段直肠癌术后吻合口漏的比较研究。

背景：本研究旨在评价两种采用新型支架的肠道粪便分流方法预防中、下段直肠癌术后吻合口漏的可行性和安全性，并比较其优缺点，供临床应用。方法：回顾性分析2021年6月至2024年3月在永川医院行腹腔镜直肠癌根治术（LAR）的101例患者。患者分为三组：回肠组26例（使用回肠末端支架），原位组54例（使用直肠原位覆盖支架），对照组21例。比较三组患者术前、手术及术后资料。结果：两组患者的基线特征、手术资料、术后吻合口漏及其他并发症发生率均无显著差异。原位组术后住院时间（12.6±3.7 vs 11.4±2.9d, p > 0.05）、总住院费用（48903.58±7094.14 vs 82205.77±12222.41元，p > 0.05）与对照组比较，差异均无统计学意义。此外，在这些比较中，回肠组的表现比对照组差。结合吻合口闭合手术相关数据，原位组和回肠组在总住院费用上有显著优势（59085.88±7460.79元vs 48903.58±7094.14元vs 81418.32±11186.78元）。结论：两种粪便分流方式术后吻合口瘘发生率均可接受，可避免二次吻合手术。原位覆膜支架法效果较好，不仅节省了住院时间和费用，而且术后处理更简单、有效。

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