Pelvic Floor Peritoneum Closure Reduces Severe Postoperative Complications in Rectal Cancer Patients After Laparoscopic Anterior Rectal Resection.

IF 1.1 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-02-01 DOI:10.1097/SLE.0000000000001226

Jie Fu, Xuehua Zhang, Gaohua Li, Zhenzhao Xu, Jinfan Zhou, Haitao Yuan, Jiafei Xi, Yanan Wang

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引用次数: 0

Abstract

Background: Laparoscopic anterior rectal resection (LAR) is a commonly performed surgery for rectal cancer patients. Pelvic floor peritoneum closure (PC), a vital procedure in conventional anterior rectal resection, is not routinely performed in LAR.

Study design: A total of 1118 consecutive patients with rectal cancer receiving LAR were included in this retrospective study. Patients were allocated into the PC group and the non-PC group. The occurrence of postoperative complications was compared between the 2 groups. Influential factors in anastomotic leakage (AL) were explored using univariate and multivariate logistic regression.

Results: There was no difference between the groups in terms of baseline characteristics. The occurrence of postoperative complications was similar between the groups. The PC group had significantly shorter postoperative hospitalization and longer operation duration compared with the non-PC group. The occurrences of Clavien-Dindo (CD) III-IV complications, CD III-IV AL, and reoperation were significantly lower in the PC group than the non-PC group. PC and a protective ileostomy were independent protective factors for CD III-IV AL.

Conclusion: PC could reduce the occurrence of CD III-IV complications, especially CD III-IV AL, and the rate of secondary surgery, especially in patients with a lower body mass index and patients who did not receive protective ileostomies.

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腹腔镜直肠前切除术后，盆腔底腹膜闭合可减少癌症患者术后严重并发症。

背景：腹腔镜直肠前切除术（LAR）是癌症患者的常用手术。盆腔底腹膜闭合术（PC）是传统直肠前切除术中的一项重要手术，但在LAR中并不常见。研究设计：本回顾性研究共纳入1118例接受LAR的连续直肠癌患者。将患者分为PC组和非PC组。比较两组患者术后并发症的发生情况。采用单因素和多因素logistic回归方法探讨吻合口瘘的影响因素。结果：两组在基线特征方面没有差异。两组术后并发症的发生率相似。与非PC组相比，PC组的术后住院时间明显缩短，手术持续时间更长。PC组的Clavien-Dindo（CD）III-IV并发症、CD III-IV AL和再次手术的发生率显著低于非PC组。PC和保护性回肠造口术是CD III-IV AL的独立保护因素。

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

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.