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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (06) : 621 -624. doi: 10.3877/cma.j.issn.1674-3946.2021.06.010

论著

Overlap吻合与FEEA在腹腔镜结肠癌根治术中的临床疗效对比研究
王兴琴1, 谢铭1,(), 张桃1, 宁伟伟1, 梁金龙1, 刘振兴1   
  1. 1. 563000 遵义医科大学附属医院
  • 收稿日期:2021-02-02 出版日期:2021-12-26
  • 通信作者: 谢铭

Comparative study on clinical effects of Overlap anastomosis and FEEA in laparoscopic radical colon cancer resection

Xingqin Wang1, Ming Xie1,(), Tao Zhang1, Weiwei Ning1, Jinlong Liang1, Zhenxing Liu1   

  1. 1. Affiliated Hospital of Zunyi Medical University, Guizhou 563000, China
  • Received:2021-02-02 Published:2021-12-26
  • Corresponding author: Ming Xie
  • Supported by:
    National Health Commission Medical and Health Science and Technology Development Research Center Project(WA2020RW12)
引用本文:

王兴琴, 谢铭, 张桃, 宁伟伟, 梁金龙, 刘振兴. Overlap吻合与FEEA在腹腔镜结肠癌根治术中的临床疗效对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2021, 15(06): 621-624.

Xingqin Wang, Ming Xie, Tao Zhang, Weiwei Ning, Jinlong Liang, Zhenxing Liu. Comparative study on clinical effects of Overlap anastomosis and FEEA in laparoscopic radical colon cancer resection[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(06): 621-624.

目的

探讨Overlap吻合与功能性端端吻合(FEEA)在腹腔镜结肠癌根治术中的临床疗效。

方法

回顾性队列分析2018年1月至2020年1月期间行全腹腔镜结肠癌根治术88例患者的临床资料,根据吻合方式不同分为两组,其中FEEA组42例,Overlap组46例。用SPSS 18.0统计软件进行统计分析,围术期各项指标、生活质量评分(QOL)等计量资料采用(±s)表示,独立t检验;术后并发症等计数资料采用χ2检验及fisher精确检验进行比较。P<0.05为差异有统计学意义。

结果

Overlap组的手术时间、术后排气时间、术后进食时间及术后住院时间均较FEEA组短(P<0.05);两组患者的术中出血量、腹壁切口长度、术后24 h疼痛评分及两组患者术后1、3、6个月生活质量评分差异均无统计学意义(P>0.05); FEEA组术后并发症总发生率为11.9%(5/42),Overlap组的总发生率为4.3%(2/46),两组差异无统计学意义(P>0.05)。

结论

Overlap吻合方式可以在不增加术后并发症发生率的情况下缩短手术时间、加快术后恢复。

Objective

To investigate the clinical outcomes of Overlap anastomosis and FEEA in laparoscopic radical colon cancer resection.

Methods

The clinical data of 88 patients underwent total laparoscopic radical colon cancer resection from January 2018 to January 2020 were analyzed retrospectively. All of 88 patients were divided into the FEEA group (n=42cases) and the Overlap group (n=46 cases). Statistical analysis were performed by using SPSS18.0 software. The measurement data such as perioperative indicators, quality of life score (QOL) were expressed as (±s), the difference between the two groups were examined by using t test. The count data including postoperative complications were examined by using χ2 test and the difference between the two groups were examined by using Fisher’s exact test. A P value of <0.05 was considered as statistically significant difference.

Results

The operation time, postoperative exhausting and feeding time and the length of hospitliztion in the Overlap group were shorter than those in the FEEA group respectively (P<0.05). There were no significant difference between two groups in terms of blood loss, abdominal incision length, postoperative 24 h pain score, and quality of life on 1, 3 and 6 months after surgery (P>0.05). Additionally, there was no statistical significance in terms of total incidence of complications between two groups (11.9% vs. 4.3% P>0.05).

Conclusion

The Overlap anastomosis could reduce the operation time with enhanced the postoperative recovery and lower incidence of complications.

表1 88例结肠癌患者术中不同吻合方式两组患者一般资料比较[(±s),例]
图1 全腹腔镜下结肠癌根治术Overlap吻合[1A:距离肿瘤边缘约10 cm处离断远端结肠;1B:距离回盲部约10 cm处离断回肠末端;1C:在距离结肠断端6 cm处与近端回肠行Overlap吻合;1D:以直线切割闭合器关闭共同开口;1E: Overlap吻合完成后;1F:剖开后的肿瘤标本]
图2 全腹腔镜下结肠癌根治术FEEA吻合[2A:距离肿瘤边缘约15 cm处离断远端结肠;2B:距离回盲部约15 cm处离断回肠末端;2C:将结肠断端与近端回肠断端对齐行FEEA; 2D:以直线切割闭合器关闭共同开口;2E: FEEA完成后;2F:剖开后的肿瘤标本]
表2 88例结肠癌患者不同吻合方式两组患者围术期指标比较(±s)
表3 88例结肠癌患者不同吻合方式两组患者术后并发症比较(例)
表4 88例结肠癌患者不同吻合方式两组患者术后生活质量评分的比较(分)
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