J-M Jung, S Yang, Y S Yoon, Y I Kim, M H Kim, J L Lee, C W Kim, I J Park, S-B Lim, C S Yu
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The AL rate was assessed after the inverse probability of treatment weighting (IPTW) adjustments.</p><p><strong>Results: </strong>After IPTW adjustment, no significant differences in baseline characteristics were observed between the two groups. Overall complication and AL rates were 12.0% and 4.5%, respectively. Although no difference in overall complications was observed between the two groups, patients in the CO group had a significantly lower AL rate than the non-CO group (1.7% vs. 10.3%, p = 0.010). Logistic regression analysis revealed that the CO procedure was a protective factor against AL (IPTW-adjusted OR 0.153, 95% CI 0.036-0.643, p = 0.010).</p><p><strong>Conclusions: </strong>The application of the CO procedure in patients with LAR who were not indicated for stoma creation may contribute to reducing the risk of AL.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"160"},"PeriodicalIF":2.9000,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354487/pdf/","citationCount":"0","resultStr":"{\"title\":\"Does robotic circumferential oversewing reduce anastomotic leakage in stapled anastomosis for rectal cancer surgery?\",\"authors\":\"J-M Jung, S Yang, Y S Yoon, Y I Kim, M H Kim, J L Lee, C W Kim, I J Park, S-B Lim, C S Yu\",\"doi\":\"10.1007/s10151-025-03207-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Anastomotic leakage (AL) remains a challenging complication of rectal cancer surgery. 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引用次数: 0
摘要
背景：吻合口瘘（AL）仍然是直肠癌手术中一个具有挑战性的并发症。在诊断为AL低风险的患者中，通常在不造口的情况下进行低前切除术（LAR）。然而，即使在被认为是低风险的患者中，AL仍然可能发生。本研究评估了周向缝合（CO）对没有粪便转移的机器人LAR患者AL的影响。方法：我们回顾性分析了225例直肠癌患者的资料，这些患者接受了机器人腹腔镜手术，没有粪便转移。他们被分为一氧化碳组和非一氧化碳组。CO组沿着圆形订书钉线进行包缝。在处理加权逆概率（IPTW）调整后评估AL率。结果：IPTW调整后，两组患者基线特征无显著差异。总并发症和AL发生率分别为12.0%和4.5%。虽然两组之间的总并发症没有差异，但CO组患者的AL发生率明显低于非CO组（1.7% vs. 10.3%, p = 0.010）。Logistic回归分析显示CO程序是预防AL的保护因素（iptw校正OR 0.153, 95% CI 0.036-0.643, p = 0.010）。结论：在未指征造口的LAR患者中应用CO手术可能有助于降低AL的风险。
Does robotic circumferential oversewing reduce anastomotic leakage in stapled anastomosis for rectal cancer surgery?
Background: Anastomotic leakage (AL) remains a challenging complication of rectal cancer surgery. In patients diagnosed with low risk of AL, low anterior resection (LAR) is often performed without creating a stoma. However, AL can still occur even in patients considered to be at low risk. This study assessed the effects of circumferential oversewing (CO) on AL in patients undergoing robotic LAR without fecal diversion.
Methods: We retrospectively reviewed data from 225 patients with rectal cancer who underwent robotic LAR without fecal diversion. They were divided into CO and non-CO groups. The CO group received oversewing along the circular staple line. The AL rate was assessed after the inverse probability of treatment weighting (IPTW) adjustments.
Results: After IPTW adjustment, no significant differences in baseline characteristics were observed between the two groups. Overall complication and AL rates were 12.0% and 4.5%, respectively. Although no difference in overall complications was observed between the two groups, patients in the CO group had a significantly lower AL rate than the non-CO group (1.7% vs. 10.3%, p = 0.010). Logistic regression analysis revealed that the CO procedure was a protective factor against AL (IPTW-adjusted OR 0.153, 95% CI 0.036-0.643, p = 0.010).
Conclusions: The application of the CO procedure in patients with LAR who were not indicated for stoma creation may contribute to reducing the risk of AL.
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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