{"title":"腹内吻合与体外吻合治疗右侧结肠癌的肿瘤学价值。","authors":"Katsuya Watanabe, Taro Oshikiri, Kyosuke Habu, Yusuke Ogi, Hiroki Sugishita, Satoshi Akita, Motohira Yoshida, Shigehiro Koga, Kei Ishimaru, Yuji Watanabe","doi":"10.1007/s00595-025-03054-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The incidence of colorectal cancer (CRC) is increasing worldwide. Surgical resection is the primary treatment for localized cases with the aim of complete tumor removal and adequate lymph node dissection. Intracorporeal anastomosis (IA) has gained popularity in colorectal surgery; however, its oncological benefits over extracorporeal anastomosis (EA) remain unclear.</p><p><strong>Methods: </strong>This retrospective study at Ehime University Hospital included 118 right-sided colon cancer patients (54 IA and 64 EA) treated between 2018 and 2023. Outcomes such as distal margin (DM) length and number of lymph nodes dissected were assessed.</p><p><strong>Results: </strong>In the IA group, the DM was significantly longer (117.9 ± 49.5 mm vs. 78.2 ± 30.1 mm, p < 0.001) and more lymph nodes were harvested (22.2 ± 10.0 vs. 18.2 ± 9.9, p = 0.031). A multivariate analysis identified IA as an independent factor for DM > 10 cm (odds ratio [OR] = 0.25, p = 0.001) and > 12 dissected lymph nodes (OR = 0.15, p = 0.006). Patients with IA resumed ingestion and defecation sooner, with shorter hospital stays.</p><p><strong>Conclusions: </strong>IA provides significant advantages for DM length and lymph node dissection, suggesting that it may be preferable for right-sided colon cancer surgery.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Oncological merits of intracorporeal anastomosis versus extracorporeal anastomosis for right-sided colon cancer.\",\"authors\":\"Katsuya Watanabe, Taro Oshikiri, Kyosuke Habu, Yusuke Ogi, Hiroki Sugishita, Satoshi Akita, Motohira Yoshida, Shigehiro Koga, Kei Ishimaru, Yuji Watanabe\",\"doi\":\"10.1007/s00595-025-03054-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The incidence of colorectal cancer (CRC) is increasing worldwide. Surgical resection is the primary treatment for localized cases with the aim of complete tumor removal and adequate lymph node dissection. Intracorporeal anastomosis (IA) has gained popularity in colorectal surgery; however, its oncological benefits over extracorporeal anastomosis (EA) remain unclear.</p><p><strong>Methods: </strong>This retrospective study at Ehime University Hospital included 118 right-sided colon cancer patients (54 IA and 64 EA) treated between 2018 and 2023. Outcomes such as distal margin (DM) length and number of lymph nodes dissected were assessed.</p><p><strong>Results: </strong>In the IA group, the DM was significantly longer (117.9 ± 49.5 mm vs. 78.2 ± 30.1 mm, p < 0.001) and more lymph nodes were harvested (22.2 ± 10.0 vs. 18.2 ± 9.9, p = 0.031). A multivariate analysis identified IA as an independent factor for DM > 10 cm (odds ratio [OR] = 0.25, p = 0.001) and > 12 dissected lymph nodes (OR = 0.15, p = 0.006). Patients with IA resumed ingestion and defecation sooner, with shorter hospital stays.</p><p><strong>Conclusions: </strong>IA provides significant advantages for DM length and lymph node dissection, suggesting that it may be preferable for right-sided colon cancer surgery.</p>\",\"PeriodicalId\":22163,\"journal\":{\"name\":\"Surgery Today\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-05-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery Today\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00595-025-03054-6\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-025-03054-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
目的：结直肠癌（CRC）的发病率在全球范围内呈上升趋势。手术切除是局部病例的主要治疗方法，目的是完全切除肿瘤和充分清扫淋巴结。肠腔内吻合术（IA）在结直肠手术中得到了广泛的应用；然而，其相对于体外吻合（EA）的肿瘤学益处尚不清楚。方法：本回顾性研究纳入了2018年至2023年在爱媛大学医院治疗的118例右侧结肠癌患者（54例IA和64例EA）。评估远端边缘（DM）长度和淋巴结清扫数量等结果。结果：IA组DM明显变长（117.9±49.5 mm vs. 78.2±30.1 mm, p 10 cm）（比值比[OR] = 0.25, p = 0.001），淋巴结清扫（OR = 0.15, p = 0.006）。IA患者恢复进食和排便更快，住院时间更短。结论：IA在DM长度和淋巴结清扫方面具有明显优势，提示其可能更适合右侧结肠癌手术。
Oncological merits of intracorporeal anastomosis versus extracorporeal anastomosis for right-sided colon cancer.
Purpose: The incidence of colorectal cancer (CRC) is increasing worldwide. Surgical resection is the primary treatment for localized cases with the aim of complete tumor removal and adequate lymph node dissection. Intracorporeal anastomosis (IA) has gained popularity in colorectal surgery; however, its oncological benefits over extracorporeal anastomosis (EA) remain unclear.
Methods: This retrospective study at Ehime University Hospital included 118 right-sided colon cancer patients (54 IA and 64 EA) treated between 2018 and 2023. Outcomes such as distal margin (DM) length and number of lymph nodes dissected were assessed.
Results: In the IA group, the DM was significantly longer (117.9 ± 49.5 mm vs. 78.2 ± 30.1 mm, p < 0.001) and more lymph nodes were harvested (22.2 ± 10.0 vs. 18.2 ± 9.9, p = 0.031). A multivariate analysis identified IA as an independent factor for DM > 10 cm (odds ratio [OR] = 0.25, p = 0.001) and > 12 dissected lymph nodes (OR = 0.15, p = 0.006). Patients with IA resumed ingestion and defecation sooner, with shorter hospital stays.
Conclusions: IA provides significant advantages for DM length and lymph node dissection, suggesting that it may be preferable for right-sided colon cancer surgery.
期刊介绍：
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.
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