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中华普外科手术学杂志(电子版) ›› 2024, Vol. 18 ›› Issue (01) : 9 -13. doi: 10.3877/cma.j.issn.1674-3946.2024.01.003

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腹腔镜右半结肠癌D3根治术消化道吻合重建方式的选择
周岩冰(), 刘晓东   
  1. 266003 山东青岛,青岛大学附属医院胃肠外科
  • 收稿日期:2023-11-07 出版日期:2024-02-26
  • 通信作者: 周岩冰
  • 基金资助:
    山东省自然科学基金(ZR2021MH001)

Choice of digestive tract reconstruction after laparoscopic right colectomy of colon cancer

Yanbing Zhou(), Xiaodong Liu   

  1. Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao Shandong Province 266003, China
  • Received:2023-11-07 Published:2024-02-26
  • Corresponding author: Yanbing Zhou
引用本文:

周岩冰, 刘晓东. 腹腔镜右半结肠癌D3根治术消化道吻合重建方式的选择[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 9-13.

Yanbing Zhou, Xiaodong Liu. Choice of digestive tract reconstruction after laparoscopic right colectomy of colon cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 9-13.

腹腔镜右半结肠D3根治术目前被认为是右半结肠癌的标准治疗方法,右半结肠切除后消化道吻合重建方式目前主要分为腹腔外回肠-结肠吻合(EIA)及腹腔内回肠-结肠吻合(IIA)。EIA吻合技术上操作更简单。由于整个IIA在腹腔内进行,因此具有肠道功能恢复快、切口小等优点。然而,IIA耗时长且技术难度大,限制了它的广泛使用,而且腹腔内吻合是否增加术后腹腔感染及吻合口漏的发生,尚未澄清。因此,目前重建方式的选择仍存在争议。本文将阐述腹腔镜右半结肠癌D3根治术消化道吻合重建方式及临床效果,旨在为临床医生的选择提供更多参考。

Laparoscopic right colectomy is considered to be the standard treatment of colon cancer, the digestive tract reconstruction after resection divides into extracorporeal ileocolic anastomosis (EIA) and intracorporeal anastomosis ileocolic anastomosis (IIA) ; EIA is simple to perform, whiles the IIA is performed in the abdominal cavity, which leads to fast intestinal function recovery and small incision. However, IIA is time-consuming and difficult in technically, which limit the widespread use, and it is not clear whether intraperitoneal anastomosis increases the incidence of postoperative intra-abdominal infection and anastomotic leakage. Therefore, the choice of reconstruction is still controversial. This article will describe the methods and clinical results of digestive tract reconstruction after laparoscopic right colectomy, in order to provide more references for clinicians.

[1]
Schlinkert RT. Laparoscopic-assisted right hemicolectomy[J]. Dis Colon Rectum, 1991, 34(11): 1030–1031.
[2]
Clinical Outcomes of Surgical Therapy Study Group,Nelson HSargent DJ,et al. A comparison of laparoscopically assisted and open colectomy for colon cancer[J]. N Engl J Med, 2004, 350(20): 2050–2059.
[3]
Guillou PJQuirke PThorpe H,et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer(MRC CLASICC trial): multicentre,randomised controlled trial[J]. Lancet, 2005, 365(9472): 1718–1726.
[4]
郑民华,何子锐. 腹腔镜右半结肠癌根治术的热点与未来发展[J/CD]. 中华普外科手术学杂志(电子版), 2019, 13(05): 433–436.
[5]
杜晓辉,刘帛岩. 中国腹腔镜右半结肠癌根治术术式选择与规范化[J/CD]. 中华普外科手术学杂志(电子版), 2022, 16(05): 478–481.
[6]
王贵英. 中国腹腔镜右半结肠癌根治术需要规范的几个问题[J/CD]. 中华普外科手术学杂志(电子版), 2022, 16(05): 482–486.
[7]
卢晓云,王继伟,谢銘. 中国腹腔镜右半结肠癌根治术淋巴结清扫争议与思考[J/CD]. 中华普外科手术学杂志(电子版), 2022, 16(05): 487–491.
[8]
Phillips EHFranklin MCarroll BJ,et al. Laparoscopic colectomy[J]. Ann Surg, 1992, 216(6): 703–707.
[9]
Bollo JTurrado VRabal A,et al. Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy(IEA trial)[J]. Br J Surg, 2020, 107(4): 364–372.
[10]
Aiolfi ABona DGuerrazzi G,et al. Intracorporeal Versus Extracorporeal Anastomosis in Laparoscopic Right Colectomy: An Updated Systematic Review and Cumulative Meta-Analysis[J]. J Laparoendosc Adv Surg Tech A, 2020, 30(4): 402–412.
[11]
Emile SHElfeki HShalaby M,et al. Intracorporeal versus extracorporeal anastomosis in minimally invasive right colectomy: an updated systematic review and meta-analysis[J]. Tech Coloproctol, 2019, 23(11): 1023–1035.
[12]
Creavin BBalasubramanian ICommon M,et al. Intracorporeal vs extracorporeal anastomosis following neoplastic right hemicolectomy resection: a systematic review and meta-analysis of randomized control trials[J]. Int J Colorectal Dis, 2021, 36(4): 645–656.
[13]
Ferrer-Márquez MRubio-Gil FTorres-Fernández R,et al. Intracorporeal Versus Extracorporeal Anastomosis in Patients Undergoing Laparoscopic Right Hemicolectomy: A Multicenter Randomized Clinical Trial(The IVEA-study)[J]. Surg Laparosc Endosc Percutan Tech, 2021, 31(4): 408–413.
[14]
Seno EAllaix MEAmmirati CA,et al. Intracorporeal or extracorporeal ileocolic anastomosis after laparoscopic right colectomy: cost analysis of the Torino trial[J]. Surg Endosc, 2023, 37(1): 479–485.
[15]
Bashir Mohamed KHansen CHKrarup PM,et al. The impact of anastomotic leakage on recurrence and long-term survival in patients with colonic cancer: A systematic review and meta-analysis[J]. Eur J Surg Oncol, 2020, 46(3): 439–447.
[16]
Allaix MEDegiuli MBonino MA,et al. Intracorporeal or Extracorporeal Ileocolic Anastomosis After Laparoscopic Right Colectomy: A Double-blinded Randomized Controlled Trial[J]. Ann Surg, 2019, 270(5): 762–767.
[17]
Sun RZhang YFeng B,et al. Intracorporeal Anastomosis Versus Extracorporeal Anastomosis in Laparoscopic Right Colectomy: An Observational Cohort Study[J]. World J Surg, 2023, 47(3): 785–795.
[18]
Zhong HCai ZLu J,et al. Pathological and perioperative outcomes of extracorporeal versus intracorporeal anastomosis in laparoscopic transverse colon cancer resection: retrospective multicentre study[J]. BJS Open, 2023, 7(3): zrad045.
[19]
Ibáñez NAbrisqueta JLuján J,et al. Isoperistaltic versus antiperistaltic ileocolic anastomosis. Does it really matter?Results from a randomised clinical trial(ISOVANTI)[J]. Surg Endosc, 2019, 33(9): 2850–2857.
[20]
Dohrn NYikilmaz HLaursen M,et al. Intracorporeal Versus Extracorporeal Anastomosis in Robotic Right Colectomy: A Multicenter,Triple-blind,Randomized Clinical Trial[J]. Ann Surg, 2022, 276(5): e294–e301.
[21]
Squillaro AIKohn JWeaver L,et al. Intracorporeal or extracorporeal anastomosis after minimally invasive right colectomy: a systematic review and meta-analysis[J]. Tech Coloproctol, 2023, 27(11): 1007–1016.
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