目的:本研究旨在探讨放置双腔冲洗-吸引管(DLIST)对直肠癌术后吻合口缺损(AD)闭合的影响。
方法:这项研究是在由一名外科医生管理的两个中心进行的,两者都采用了相同的治疗方法。2011年1月至2020年6月直肠癌术后AD患者入选,根据是否PD分为被动引流(PD)组和DLIST组,在直肠癌手术中,已替换为DLIST。评估DLIST对AL的影响。
结果:DLIST组中有76例患者,PD组中有52例患者。据报道,DLIST组的闭合率较高(DLIST组46例,对于60.5%的闭合率,PD组21名患者,关闭率为40.4%。HR=3.05;95%CI:1.79-5.19;P<0.001)。DLIST组的住院时间和治疗费用均较低(54天[四分位距,IQR:41-17]天vs.112天[IQR:66-27]天,P=0.005;和$18,721[IQR:$14,982-4,960]vs.$40,840[IQR:$20,932-50,529],P<0.001)。
结论:放置DLIST可能是治疗直肠癌术后AD的有效方法。与PD相比,应用DLIST治疗AD的成本较低,住院时间较短。
This study aimed to investigate the effect of placement of double-lumen irrigation-suction tubes (DLIST) on the
closure of anastomotic defect (AD) after rectal cancer surgery.
The study was carried out at two centers managed by one surgeon, both adopted the same treatments. Patients with postoperative AD after rectal cancer surgery from January 2011 to June 2020 were eligible and were divided into a passive drainage (PD) group and a DLIST group according to whether the PD, placed in the rectal cancer surgery, had been replaced with the DLIST. The effect of DLIST on the AL was evaluated.
There distributed 76 patients in the DLIST group and 52 in the PD group. A higher
closure rate was reported in the DLIST group (46 patients in DLIST group, for a
closure rate of 60.5%, and 21 patients in PD group, for a
closure rate of 40.4%. HR = 3.05; 95% CI: 1.79-5.19; P < 0.001). Both length of stay and costs of the treatment in the DLIST group were lower (54 days [interquartile range, IQR: 41-17] days vs. 112 days [IQR: 66-27] days, P = 0.005; and $18,721 [IQR: $14,982-4,960] vs. $40,840 [IQR: $20,932-50,529], P < 0.001).
Placement of DLIST might serve as an effective method for treating AD following rectal cancer surgery. In comparison with PD, it costs lower to apply DLIST in the treatment of AD and the length of stay is shorter.