지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.100 No.2
- 발행연도
- 2021.2
- 수록면
- 100 - 108 (9page)
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초록· 키워드
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Purpose: Diverting stoma (DS) and transanal tube (TAT) are the 2 main procedures for reducing anastomotic leak (AL) in rectal cancer surgery. However, few studies have compared the protective effect of the 2 modalities against AL.
Methods: Total of 165 patients with mid rectal cancer, who underwent curative resection from 2012 to 2017, were included. Clinical characteristics and outcomes were compared. Risk factors for AL were identified using multivariate analysis.
Results: The DS group had lower tumor location, higher rates of neoadjuvant concurrent chemoradiotherapy, and longer operative time than the TAT group. However, the level of the anastomosis did not show statistically significant differences (DS: 4.6 cm vs. TAT: 4.9 cm, P = 0.061). AL occurred in 14 of the 165 patients (8.5%), with 10 (10.2%) in the DS group and 4 (6.0%) in the TAT group (P = 0.405). On multivariate analysis, only low body mass index (BMI) and smoking were significantly related to AL. Neither the protection method nor neoadjuvant chemoradiotherapy demonstrated statistical differences in AL. Seven of 10 patients in the DS group who experienced AL were treated conservatively, while all 4 in the TAT group underwent reoperation.
Conclusion: TAT seems to have comparable protective effect against AL to DS. However, in AL, DS appeared to be more effective in preventing reoperation. Therefore, DS is recommended in patients with low BMI or smoking, and with an expected higher probability of morbidity or mortality in case of reoperation. In other cases, TAT may be considered as an alternative to DS.
Methods: Total of 165 patients with mid rectal cancer, who underwent curative resection from 2012 to 2017, were included. Clinical characteristics and outcomes were compared. Risk factors for AL were identified using multivariate analysis.
Results: The DS group had lower tumor location, higher rates of neoadjuvant concurrent chemoradiotherapy, and longer operative time than the TAT group. However, the level of the anastomosis did not show statistically significant differences (DS: 4.6 cm vs. TAT: 4.9 cm, P = 0.061). AL occurred in 14 of the 165 patients (8.5%), with 10 (10.2%) in the DS group and 4 (6.0%) in the TAT group (P = 0.405). On multivariate analysis, only low body mass index (BMI) and smoking were significantly related to AL. Neither the protection method nor neoadjuvant chemoradiotherapy demonstrated statistical differences in AL. Seven of 10 patients in the DS group who experienced AL were treated conservatively, while all 4 in the TAT group underwent reoperation.
Conclusion: TAT seems to have comparable protective effect against AL to DS. However, in AL, DS appeared to be more effective in preventing reoperation. Therefore, DS is recommended in patients with low BMI or smoking, and with an expected higher probability of morbidity or mortality in case of reoperation. In other cases, TAT may be considered as an alternative to DS.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
Rahbari NN / 2010 / Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer / Surgery 147:339~351
Paun BC / 2010 / Postoperative complications following surgery for rectal cancer / Ann Surg 251:807~818
McArdle CS / 2005 / Impact of anastomotic leakage on longterm survival of patients undergoing curative resection for colorectal cancer / Br J Surg 92:1150~1154
Ha GW / 2017 / Oncologic impact of anastomotic leakage following colorectal cancer surgery: a systematic review and meta-analysis / Ann Surg Oncol 24:3289~3299
Mirnezami A / 2011 / Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis / Ann Surg 253:890~899
Paun BC / 2010 / Postoperative complications following surgery for rectal cancer / Ann Surg 251:807~818
McArdle CS / 2005 / Impact of anastomotic leakage on longterm survival of patients undergoing curative resection for colorectal cancer / Br J Surg 92:1150~1154
Ha GW / 2017 / Oncologic impact of anastomotic leakage following colorectal cancer surgery: a systematic review and meta-analysis / Ann Surg Oncol 24:3289~3299
Mirnezami A / 2011 / Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis / Ann Surg 253:890~899
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