摘要
Abstract
Objective·To explore the clinical effects of intra-abdominal anastomosis in laparoscopic right hemicolectomy.Methods·Clinical data were collected from 92 patients diagnosed with right-sided colon cancer who underwent laparoscopic right hemicolectomy at Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,from January 2020 and February 2024.The patients were divided into an intra-abdominal anastomosis group and an extra-abdominal anastomosis group according to the intraoperative anastomosis method.Perioperative general data,intraoperative conditions,postoperative recovery,and short-term complications within 30 d after surgery were collected and compared between the two groups.Results·After propensity score matching,64 well-matched patients were obtained,with 32 cases in the intra-abdominal anastomosis group and 32 cases in the extra-abdominal anastomosis group.The intraoperative blood loss in the intra-abdominal anastomosis group was significantly lower than that in the extra-abdominal anastomosis group(P<0.001),and the length of the auxiliary incision was also shorter(P<0.001).Patients in the intra-abdominal anastomosis group had shorter time to first flatus(P=0.012)and time to first defecation(P=0.003),as well as lower postoperative pain scores(P<0.001).The overall incidence of short-term complications and the incidence of surgical site infection in the intra-abdominal anastomosis group were 21.88%and 6.25%,respectively,which were significantly lower than those in the extra-abdominal anastomosis group(37.50%and 28.13%,respectively;P=0.041 and P=0.032).Within 30 d postoperatively,the intra-abdominal anastomosis group had significantly lower severe complication(Clavien-Dindo≥grade Ⅱ)rate compared with the extra-abdominal anastomosis group(12.50%vs 31.25%,P=0.045).Conclusion·Compared with extra-abdominal anastomosis in laparoscopic right hemicolectomy,intra-abdominal anastomosis demonstrates significant advantages in terms of reduced intraoperative blood loss,less surgical trauma,faster recovery of intestinal function,lower postoperative pain,and a lower incidence of short-term complications.关键词
右半结肠癌/腹腔镜下右半结肠切除术/腹腔内吻合/腹腔外吻合Key words
right-sided colon cancer/laparoscopic right hemicolectomy/intra-abdominal anastomosis/extra-abdominal anastomosis分类
医药卫生
