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首页> 外文期刊>Surgical Endoscopy >Who needs diverting ileostomy following laparoscopic low anterior resection in rectal cancer patients? Analysis of 417 patients in a single institute
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Who needs diverting ileostomy following laparoscopic low anterior resection in rectal cancer patients? Analysis of 417 patients in a single institute

机译：谁需要在直肠癌患者腹腔镜低前切除术后转移eLEOFTOMY？ 单一研究所417例患者分析

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Background Anastomotic leakage (AL) is one of the most serious complications after low anterior resection (LAR) for rectal cancer, and the significance of diverting stoma to prevent AL is still controversial. The aim of this study is to clarify the potential benefits and safety of diverting ileostomy (DI) following laparoscopic LAR in rectal cancer patients. Methods This was a retrospective cohort study of 417 rectal cancer patients who underwent laparoscopic LAR in a single institute. The risk factors for AL and the DI-related morbidity were assessed. Results DI was performed in 226 patients (54.2%). The incidence rates of symptomatic AL showed no significant difference between patients with and without DI (8.4% vs. 10.0%, p = 0.612). AL requiring a surgical intervention was relatively lower in patients with DI than in those without DI (1.8% vs. 4.7%, p = 0.097). DI construction was an independent risk factor for AL requiring a surgical intervention (OR 3.47, p = 0.041), as was the serum albumin level (p = 0.003), and being male was a relative risk factor (p = 0.058). Focusing on sex, the rate of AL requiring a surgical intervention was significantly different in male (1.7 and 7.9%, p = 0.021) but not in female patients (1.9 and 1.1%, p = 1.000) with and without DI. The DI construction-related morbidity was 9.7%, and no patient required a reoperation. Of 226 patients with DI, 209 (92.5%) underwent stoma closure 118 days (median 30-509 days) after LAR. The stoma closure-related morbidity was 9.1% and 1 patient (0.5%) required a reoperation due to anastomotic leakage. Conclusions DI following laparoscopic LAR can decrease the risk of AL, requiring a surgical intervention, especially in male patients with malnutrition. However, due to DI-related morbidity, DI is not recommended in female patients.
机译：背景技术吻合泄漏（AL）是直肠癌低前切除（LAR）后最严重的并发症之一，以及转移造口的意义仍然存在争议。本研究的目的是阐明在直肠癌患者中腹腔镜大鼠腹腔镜大鼠术（DI）的潜在益处和安全性。方法这是一项回顾性队列研究，对417名直肠癌患者进行了一项腹腔镜大腹腔镜。评估Al和DI相关发病率的危险因素。结果DI在226名患者中进行（54.2％）。症状的发病率在没有DI（8.4％与10.0％，P = 0.612）之间没有显着差异。对于DI的患者而言，需要手术干预的AL比没有DI的那些（1.8％对4.7％，P = 0.097）。 DI施工是需要手术干预（或3.47，P = 0.041）的Al的独立危险因素，如血清白蛋白水平（p = 0.003），并且是男性是相对危险因素（p = 0.058）。专注于性别，需要手术干预的Al率在雄性（1.7和7.9％，P = 0.021）中显着差异，但不含女性患者（1.9和1.1％，P = 1.000），没有DI。 DI施工相关的发病率为9.7％，没有患者需要重新进食。 226例DI，209例（92.5％）在LAR后118天（中位数30-509天中位）接受造口闭合。与吻合口径渗漏引起的，造口闭合相关的发病率为9.1％，1名患者（0.5％）。结论腹腔镜下调可降低Al的风险，需要手术干预，特别是在营养不良的男性患者中。然而，由于与DI相关的发病率，在女性患者中不建议使用DI。

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  • 来源
    《Surgical Endoscopy》 |2020年第2期|共8页
  • 作者

    Shimizu Hiroki; Yamaguchi Shigeki; Ishii Toshimasa; Kondo Hiroka; Hara Kiyoka; Takemoto Kenichi; Ishikawa Shintaro; Okada Takuhisa; Suzuki Asami; Koyama Isamu;

  • 作者单位

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

    Saitama Med Univ Comprehens Canc Ctr Dept Gastroenterol Surg Int Med Ctr 1397-1 Yamane Hidaka;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    Laparoscopic low anterior resection; Diverting ileostomy; Anastomotic leakage; Sex; Stoma complication;

    机译：腹腔镜低前切除切除;转移oleoStomy;吻合泄漏;性;造香囊复杂化;

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