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首页> 外文期刊>Surgical Endoscopy >Fashioning enterotomy closure after totally laparoscopic ileocolic anastomosis for right colon cancer: a multicenter experience
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Fashioning enterotomy closure after totally laparoscopic ileocolic anastomosis for right colon cancer: a multicenter experience

机译：塑造肠球术后腹腔镜吻合术治疗右癌症术后吻合术治疗：多中心经验

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摘要

Background Laparoscopic right hemicolectomy is a commonly performed procedure. Little is known on how to perform the enterotomy closure after stapled side-to-side intracorporeal anastomosis. Method A multicentric case-controlled study has been designed to compare different ways to fashion enterotomy closure: double layer versus single layer, sewn versus stapled, and robotic versus laparoscopic approach. Furthermore, additional characteristics including sutures' materials, interrupted versus running suture and the presence of deep corner suture has been investigated. Results We collected data for 1092 patients who underwent right hemicolectomy at ten centers. We analyzed 176 robotic against 916 laparoscopic anastomosis: no significant differences were found in terms of bleedings (p = 0.455) and anastomotic leak (p = 0.405). We collected data from 126 laparoscopic sewn single-layer versus 641 laparoscopic sewn double-layer anastomosis: a significant reduction was recorded in terms of leaks in double-layer group (p = 0.02). About double-layer characteristics, we found a significant reduction of bleedings (p = 0.008) and leaks (p = 0.017) with a running suture; similarly, a reduction of bleedings (p = 0.001) and leaks (p = 0.005) was observed with the usage of deep corner closure. The presence of a barbed suture thread seemed to significantly reduce both bleedings (p = 0.001) and leaks (p = 0.001). We found no significant differences in terms of bleedings (p = 0.245) and anastomotic leak (p = 0.660) comparing sewn versus stapled anastomosis. Conclusions Fashioning a stapled ileocolic intracorporeal anastomosis, we can recommend the adoption of a double-layer enterotomy closure using a running barbed suture in the first layer. Totally, stapled closure and robotic assistance have to be considered a non-inferior alternative.
机译：背景技术腹腔镜右半聚切除术是常见的程序。关于如何在捆绑的侧向体内吻合术后进行肠球闭合的人少。方法旨在将不同的方式与时尚肠球闭合的不同方式进行比较：双层与单层，缝制与装订，以及机器人与腹腔镜接近。此外，已经研究了额外的特性，包括缝合线的材料，中断与运行缝合以及深角缝合线的存在。结果我们收集了1092名患者在十个中心接受了右半聚切除术的患者的数据。我们分析了176个针对916腹腔镜吻合术的机器人：在出血方面没有发现显着的差异（p = 0.455）和吻合泄漏（p = 0.405）。我们收集来自126个腹腔镜缝制单层的数据与641腹腔镜缝制双层吻合术：在双层组中的泄漏方面记录了显着的减少（P = 0.02）。关于双层特征，我们发现出血的显着减少（P = 0.008），并具有运行缝合线（P = 0.017）;类似地，通过使用深部闭合的使用，观察到出血的减少（P = 0.001）和泄漏（P = 0.005）。刺缝线线的存在似乎显着减少了出血（P = 0.001）和泄漏（P = 0.001）。我们发现在出血方面没有显着差异（P = 0.245）和吻合泄漏（P = 0.660）比较缝制与令人犯规的吻合术。结论塑造了套装的Eleolictoral体内吻合，我们可以使用第一层中的运行刺缝合来推荐使用双层肠球闭合闭合。完全，装订封闭和机器人辅助必须被认为是非劣等的替代方案。

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  • 来源
    《Surgical Endoscopy》 |2020年第2期|共7页
  • 作者

    Milone M.; Elmore U.; Allaix M. E.; Bianchi P. P.; Biondi A.; Boni L.; Bracale U.; Cassinotti E.; Ceccarelli G.; Corcione F.; Cuccurullo D.; Degiuli M.; De Manzini Nicolo; DUgo D.; Formisano G.; Manigrasso M.; Morino M.; Palmisano S.; Persiani R.; Reddavid R.; Rondelli F.; Velotti N.; Rosati R.; De Palma Giovanni Domenico;

  • 作者单位

    Univ Naples Federico II Dept Clin Med &

    Surg Via Pansini 5 I-80131 Naple Italy;

    Univ Vita Salute Dept Surg San Raffaele Sci Inst Milan Italy;

    Univ Turin Dept Surg Sci Turin Italy;

    Misericordia Hosp Dept Gen &

    Minimally Invas Surg Grosseto Italy;

    Univ Cattolica Sacro Cuore Polo Sci Gastroenterol Endocrino Metabol Fdn Policlin Univ Agostino;

    Univ Milan Dept Surg Fdn IRCCS Ca Granda Policlin Hosp Milan Italy;

    Univ Naples Federico II Dept Clin Med &

    Surg Via Pansini 5 I-80131 Naple Italy;

    Univ Milan Dept Surg Fdn IRCCS Ca Granda Policlin Hosp Milan Italy;

    USL Umbria 2 Dept Gen Surg San Giovanni Battista Hosp Perugia Italy;

    Monaldi Hosp Azienda Osped Colli Naples Italy;

    Monaldi Hosp Azienda Osped Colli Naples Italy;

    San Luigi Univ Hosp Dept Oncol Surg Oncol &

    Digest Surg Turin Italy;

    Univ Trieste Operat Unit Gen Surg Trieste Italy;

    Univ Cattolica Sacro Cuore Polo Sci Gastroenterol Endocrino Metabol Fdn Policlin Univ Agostino;

    Misericordia Hosp Dept Gen &

    Minimally Invas Surg Grosseto Italy;

    Univ Naples Federico II Dept Clin Med &

    Surg Via Pansini 5 I-80131 Naple Italy;

    Univ Turin Dept Surg Sci Turin Italy;

    Univ Trieste Operat Unit Gen Surg Trieste Italy;

    Univ Cattolica Sacro Cuore Polo Sci Gastroenterol Endocrino Metabol Fdn Policlin Univ Agostino;

    San Luigi Univ Hosp Dept Oncol Surg Oncol &

    Digest Surg Turin Italy;

    USL Umbria 2 Dept Gen Surg San Giovanni Battista Hosp Perugia Italy;

    Univ Naples Federico II Dept Clin Med &

    Surg Via Pansini 5 I-80131 Naple Italy;

    Univ Vita Salute Dept Surg San Raffaele Sci Inst Milan Italy;

    Univ Naples Federico II Dept Clin Med &

    Surg Via Pansini 5 I-80131 Naple Italy;

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

    Enterotomy closure; Laparoscopic colectomy; Right colon cancer;

    机译：肠球闭合;腹腔镜联合膜;权利结肠癌;

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