中国实用外科杂志2024，Vol.44Issue(8)：937-940,946,5.DOI:10.19538/j.cjps.issn1005-2208.2024.08.20
腹腔镜右半结肠切除术回结肠端侧吻合和侧侧吻合对术后肠功能和生活质量影响对比研究
Effects of end-side and side-side anastomosis following a laparoscopic right hemicolectomy on postoperative intestinal function and quality of life
摘要
Abstract
Objective To compare the effects of end-side anastomosis(ES)and side-side anastomosis(SS)following laparoscopic right hemicolectomy on postoperative intestinal function and quality of life in patients with right colon cancer.Methods A retrospective cohort study was conducted using the clinical data of patients with right colon cancer who underwent laparoscopic right hemicolectomy at Nanjing Drum Tower Hospital from June 2022 to June 2023.Patients were divided into two groups based on the anastomosis technique:the ES group(31 cases)and the SS group(64 cases).Postoperative intestinal function was assessed by the time to first flatus,time to first defecation,and the frequency and duration of diarrhea.Quality of life was evaluated using the Gastrointestinal Quality of Life Index(GIQLI).Differences in postoperative intestinal function and quality of life between the two groups were compared.Results There were no significant differences between the two groups in baseline characteristics such as age,gender,body mass index,postoperative pathological stage,American College of Anesthesiologists classification,intraoperative blood loss,number of lymph nodes harvested,postoperative complications,and length of hospital stay(P＞0.05).The time to first flatus[4.0(3.85,4.35)d vs.3.6(3.40,3.725)d]and the time to first defecation[4.5(4.30,4.80)d vs.4.1(4.00,4.30)d]in the ES group were significantly later than those in the SS group,and the difference was statistically significant(P＜0.001).Postoperative daily diarrhea frequency[4(3.0,4.0)times/d vs.5(4,6)times/d]and postoperative diarrhea duration[3(2.0,4.0)d vs.4.5(4.0,6.0)d]in ES group were lower than those in SS group,and the difference was statistically significant(P＜0.05).The GIQLI scores of the ES group at 2 weeks,1 month,and 3 months postoperatively were 69.0(65.50,73.50)points,99.0(93.00,100.00)points and 110.0(106.50,117.50)points,respectivel.The GIQLI scores of the SS group 63.0(61.00,67.00)points,76.5(72.50,81.50)points,and 104.0(96.75,109.25)points.The GIQLI scores in the ES group were higher than those in the SS group at all time points,with statistical significance(P＜0.001).Conclusion ES may be more beneficial than SS in improving postoperative intestinal function and quality of life in patients undergoing laparoscopic right hemicolectomy for right colon cancer.关键词
腹腔镜右半结肠切除术/端侧吻合/侧侧吻合/肠功能/生活质量Key words
laparoscopic right hemicolectomy/end-side anastomosis/side-side anastomosis/intestinal function/quality of life分类
医药卫生引用本文复制引用
李智伟,程伟,戈伟,邵丽华,马晓龙,范圣先,陈刚,王浩..腹腔镜右半结肠切除术回结肠端侧吻合和侧侧吻合对术后肠功能和生活质量影响对比研究[J].中国实用外科杂志,2024,44(8):937-940,946,5.基金项目
国家自然科学基金项目(No.81800452) （No.81800452）
南京鼓楼医院临床研究专项资金资助项目(No.2023-LCYJ-PY-10) （No.2023-LCYJ-PY-10）
南京大学中国医院改革发展研究院课题项目(No.NDYGN2023005) （No.NDYGN2023005）
