Intracorporeal versus Extracorporeal Anastomosis Following Laparoscopic Right Hemicolectomy for Colon Cancer: Short Term Clinical Outcomes

大腸癌腹腔鏡右側大腸切除術，體內吻合與體外吻合比較：短期術後預後經驗分享

林偉傑(Wei-Chieh Lin) ； 黃玄遠(Xuan-Yuan Huang) ； 陳志誠(Zhi-Cheng Chen) ； 王愷晟(Kai-Chen Wang) ； 張譽耀(Yu-Yao Chang)

《中華民國大腸直腸外科醫學會雜誌》 30卷1期 (2019/03) Pp. 21-27

https://doi.org/10.6312/SCRSTW.201903_30(1).10724

摘要

Purpose. The aim of this study was to compare intraoperative performance and postoperative outcomes of laparoscopic right hemicolectomy (LRHC) performed with intracorporeal anastomosis (ICA) with those of LRHC performed with extracorporeal anastomosis (ECA) in a single medical institution. Methods. The following data from our institution-maintained database were reviewed to identify patients with colon cancer who underwent LRHC during January 2017 to March 2018: demographic and disease-related characteristics, pTNM stage, intraoperative outcomes (operative time, blood loss, and number of harvested lymph nodes), and postoperative outcomes (postoperative complications, anastomotic leakage, and total number of days of hospital stay). Results. A total of 78 patients were identified, of whom 22 underwent LRHC with ICA and the remaining 56 underwent LRHC with ECA. There was no significant difference in patient demographic and disease-related characteristics. Mean operative time was shorter in the ICA group than in the ECA group (143.4 vs. 160.89 min, p = 0.048); mean measured blood loss was also lesser in the ICA group than in the ECA group (34 vs. 45.1 ml, p = 0.086). No significant difference was detected in terms of the number of harvested lymph nodes, postoperative complication rate, and anastomotic leakage rate. Conclusion. Using an ICA approach in performing LRHC is safe and results in a shorter operative time.

關鍵字

Laparoscopic right hemicolectomy ； Intracorporeal anastomosis ； Colon cancer

並列摘要

目的：在單一醫學中心大腸癌腹腔鏡右側大腸切除術，體內吻合與體外吻合術中與術後預後比較。方法：自2017年1月至2018年3月2大腸癌阻塞患者接受腹腔鏡右側大腸切除手術的回顧性研究。結果：共78位患者納入研究，22位施行體內吻合，56位施行體外吻合。在平均手術時間體內吻合組比體外吻合組短（143.4 ± 29分鐘比160.89 ± 36.4分鐘，p＝0.048），術中失血量也相對比較少（34 ± 18ml比45.1 ± 27.3ml，p＝0.086）。在術中淋巴結摘除，術後併發症，吻合處滲漏則兩組沒有差異。結論：體內吻合來施行大腸癌腹腔鏡右側大腸切除術是有功效和安全的。

並列關鍵字

腹腔鏡右側大腸切除術 ； 體內吻合 ； 大腸癌

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