Application of sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following radical resection of rectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HU Minggao ¹ ,  LI Xiangguo ¹ , GUO Biao ¹ , JIANG Yanyan ^1,2

1. Department of General Surgery, The PLA Navy Anqing Hospital, Anqing, Anhui 246003, P. R. China;
2. School of Physics and Electronic Engineering of Anqing Normal University, Anqing, Anhui 246011, P. R. China;

Corresponding?author：

LI Xiangguo, Email: horselixiangguo@qq.com

Keywords：

rectal cancer; pedicled colon; seromuscular sleeve; anastomotic leakage

DOI：

10.7507/1007-9424.201801009

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To study feasibility of sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following radical resection of rectal cancer. Method The clinical data of 11 patients with rectal cancer underwent the Dixon plus sheath technique with seromuscular sleeve of pedicled colon from January 2017 to October 2017 in the PLA Navy Anqing Hospital were analyzed. Results All the operations were completed successfully in the 11 patients with rectal cancer, including 9 cases of laparoscopy and 2 cases of laparotomy. The operative time was (255.5±51.5) min, the intraoperative bleeding was (80.0±28.3) mL, the first postoperative anal exhaust time was (4.4±2.0) d, the postoperative hospitalization time was (16.0±3.1) d. For the postoperative pathology, there were 5 cases of T4 stage, 2 cases of T3 stage, 2 cases of T2 stage, and 2 cases of T1 stage. The number of lymph node dissection was 5–23 with an average of 12.5 per case, 7 cases with lymph node metastasis. One case of lymphatic leakage and 1 case of incision infection occurred, and no anastomotic leakage and narrow occurred. After 3–10 months of follow-up (average follow-up 7 months), no local recurrence and distant metastasis were found. Conclusion Sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following radical resection of rectal cancer is feasible.

Citation： HU Minggao, LI Xiangguo, GUO Biao, JIANG Yanyan. Application of sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following radical resection of rectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(8): 970-974. doi: 10.7507/1007-9424.201801009 Copy

1.	劉德忠. 直腸癌保肛術后吻合口漏的危險因素分析. 中國醫學創新, 2014, 11(10): 25-27.
2.	陳萬青, 鄭榮壽, 張思維. 2012年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2016, 25(1): 1-8.
3.	吳在德, 吳孟超. 黃家駟外科學. 第7版. 北京: 人民衛生出版社, 2008: 1640.
4.	Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg, 1982, 69(10): 613-616.
5.	張衛, 朱曉明. 低位直腸癌保肛術后功能與療效評價. 中國實用外科雜志, 2017, 37(6): 624-628.
6.	衛星, 宋衛東. 中低位直腸癌 TME 保肛術后吻合口瘺原因分析及防治. 內蒙古醫學雜志, 2014, 47(2): 208-209.
7.	池畔, 陳致奮. 直腸癌術后吻合口漏的診斷與治療進展. 中華消化外科雜志, 2014, 13(7): 584-590.
8.	彭昌兵, 莊文. 低位直腸癌保肛術后吻合口漏的原因及防治現狀. 中國普外基礎與臨床雜志, 2014, 21(2) : 251-255.
9.	傅傳剛, 郝立強. 低位直腸癌保肛術后吻合口漏與狹窄原因及治療. 中國實用外科雜志, 2014, 34(9): 851-854.
10.	王炳舉, 劉彬, 孫成崗, 等. 直腸癌全系膜切除術后吻合口漏的危險因素分析. 中國腫瘤臨床與康復, 2014, 21(3): 270-271.
11.	戎禎祥, 蔡恒烈, 趙欣. 腹腔鏡直腸癌根治術前 MSCT 血管三維重建Riolan弓的臨床價值. 廣東醫學, 2015, 36(10): 1528-1530.
12.	渠浩, 杜燕夫, 李敏哲, 等. 腹腔鏡直腸乙狀結腸手術中近端腸管血運障礙的原因分析(附17例報告). 中國微創外科雜志, 2014, 14(5): 458-460.
13.	李建業, 李國賓, 耿強, 等. 高齡結直腸癌患者開放根治性手術并發癥及其影響因素分析. 中國普外基礎與臨床雜志, 2015, 22(4): 460-463.
14.	孔杰, 甘從存, 徐士杰, 等. 中低位直腸癌全直腸系膜切除術后吻合口瘺的危險素分析. 中國普外基礎與臨床雜志, 2016, 23(2): 210-213.
15.	Karanjia ND, Corder AP, Bearn P, et al. Leakage from stapled low anastomosis after total mesorectal excision for carcinoma of the rectum. Br J Surg, 1994, 81(8): 1224-1226.
16.	亢杰, 王云海, 阿不都外力?吾守爾, 等. 可預防性造口在直腸癌低位前切除術中的應用價值. 醫學綜述, 2014, 20(22): 4165-4170.
17.	Bakker IS, Morks AN, Hoedemaker HO, et al. The C-seal trial: colorectal anastomosis protected by a biodegradable drain fixed to the anastomosis by a circular stapler, a multi-center randomized controlled trial. BMC Surg, 2012, 12: 23.
18.	張庭澍, 羅蓬, 曹云, 等. 帶蒂大網膜覆蓋一期修補治療結腸損傷體會. 結直腸肛門外科, 2006, 12(5): 307.
19.	尚培中, 張振海, 劉緒友, 等. 帶血管蒂回腸漿肌瓣預防回結腸吻合口漏. 中國普外基礎與臨床雜志, 2000, 7(1): 51.
20.	陳乾德, 陳漢卿. " 帶蒂回腸袖帶”在直腸癌手術中的應用. 中國現代醫生, 2008, 46(35): 53-55.
21.	丁原淑, 王和厚, 陳曉玲, 等. 腸袢袖套加強吻合口法治療老年梗阻性左半結腸癌. 齊魯腫瘤雜志, 1998, 5(2): 149.
22.	陳乾德, 陳漢卿, 韓飛. 帶蒂袖狀結腸在直腸癌前切除手術中的應用研究. 中華普外科手術學雜志(電子版), 2015, 9(3): 188-191.
23.	沈薦, 李敏哲, 杜燕夫, 等. 腹腔鏡直腸癌前切除術中保留左結腸動脈與否的臨床對照研究. 中國微創外科雜志, 2014, 14(1): 22-24, 28.
24.	嚴小貴, 錢永坤, 蔣新衛. 腹腔鏡直腸癌根治術62例應用體會. 中國普外基礎與臨床雜志, 2015, 22(5): 554.
25.	楊建國, 李正平, 王志剛, 等. 漿肌瓣隧道式腸吻合在急性左半結腸穿孔一期手術中的應用. 中華臨床醫師雜志(電子版), 2012, 6(10): 2801-2802.
26.	孫寶書. 結腸一期切除帶蒂漿肌層片覆蓋吻合口預防腸瘺. 中華普通外科雜志, 2000, 15(2): 74.

1. 劉德忠. 直腸癌保肛術后吻合口漏的危險因素分析. 中國醫學創新, 2014, 11(10): 25-27.
2. 陳萬青, 鄭榮壽, 張思維. 2012年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2016, 25(1): 1-8.
3. 吳在德, 吳孟超. 黃家駟外科學. 第7版. 北京: 人民衛生出版社, 2008: 1640.
4. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg, 1982, 69(10): 613-616.
5. 張衛, 朱曉明. 低位直腸癌保肛術后功能與療效評價. 中國實用外科雜志, 2017, 37(6): 624-628.
6. 衛星, 宋衛東. 中低位直腸癌 TME 保肛術后吻合口瘺原因分析及防治. 內蒙古醫學雜志, 2014, 47(2): 208-209.
7. 池畔, 陳致奮. 直腸癌術后吻合口漏的診斷與治療進展. 中華消化外科雜志, 2014, 13(7): 584-590.
8. 彭昌兵, 莊文. 低位直腸癌保肛術后吻合口漏的原因及防治現狀. 中國普外基礎與臨床雜志, 2014, 21(2) : 251-255.
9. 傅傳剛, 郝立強. 低位直腸癌保肛術后吻合口漏與狹窄原因及治療. 中國實用外科雜志, 2014, 34(9): 851-854.
10. 王炳舉, 劉彬, 孫成崗, 等. 直腸癌全系膜切除術后吻合口漏的危險因素分析. 中國腫瘤臨床與康復, 2014, 21(3): 270-271.
11. 戎禎祥, 蔡恒烈, 趙欣. 腹腔鏡直腸癌根治術前 MSCT 血管三維重建Riolan弓的臨床價值. 廣東醫學, 2015, 36(10): 1528-1530.
12. 渠浩, 杜燕夫, 李敏哲, 等. 腹腔鏡直腸乙狀結腸手術中近端腸管血運障礙的原因分析(附17例報告). 中國微創外科雜志, 2014, 14(5): 458-460.
13. 李建業, 李國賓, 耿強, 等. 高齡結直腸癌患者開放根治性手術并發癥及其影響因素分析. 中國普外基礎與臨床雜志, 2015, 22(4): 460-463.
14. 孔杰, 甘從存, 徐士杰, 等. 中低位直腸癌全直腸系膜切除術后吻合口瘺的危險素分析. 中國普外基礎與臨床雜志, 2016, 23(2): 210-213.
15. Karanjia ND, Corder AP, Bearn P, et al. Leakage from stapled low anastomosis after total mesorectal excision for carcinoma of the rectum. Br J Surg, 1994, 81(8): 1224-1226.
16. 亢杰, 王云海, 阿不都外力?吾守爾, 等. 可預防性造口在直腸癌低位前切除術中的應用價值. 醫學綜述, 2014, 20(22): 4165-4170.
17. Bakker IS, Morks AN, Hoedemaker HO, et al. The C-seal trial: colorectal anastomosis protected by a biodegradable drain fixed to the anastomosis by a circular stapler, a multi-center randomized controlled trial. BMC Surg, 2012, 12: 23.
18. 張庭澍, 羅蓬, 曹云, 等. 帶蒂大網膜覆蓋一期修補治療結腸損傷體會. 結直腸肛門外科, 2006, 12(5): 307.
19. 尚培中, 張振海, 劉緒友, 等. 帶血管蒂回腸漿肌瓣預防回結腸吻合口漏. 中國普外基礎與臨床雜志, 2000, 7(1): 51.
20. 陳乾德, 陳漢卿. " 帶蒂回腸袖帶”在直腸癌手術中的應用. 中國現代醫生, 2008, 46(35): 53-55.
21. 丁原淑, 王和厚, 陳曉玲, 等. 腸袢袖套加強吻合口法治療老年梗阻性左半結腸癌. 齊魯腫瘤雜志, 1998, 5(2): 149.
22. 陳乾德, 陳漢卿, 韓飛. 帶蒂袖狀結腸在直腸癌前切除手術中的應用研究. 中華普外科手術學雜志(電子版), 2015, 9(3): 188-191.
23. 沈薦, 李敏哲, 杜燕夫, 等. 腹腔鏡直腸癌前切除術中保留左結腸動脈與否的臨床對照研究. 中國微創外科雜志, 2014, 14(1): 22-24, 28.
24. 嚴小貴, 錢永坤, 蔣新衛. 腹腔鏡直腸癌根治術62例應用體會. 中國普外基礎與臨床雜志, 2015, 22(5): 554.
25. 楊建國, 李正平, 王志剛, 等. 漿肌瓣隧道式腸吻合在急性左半結腸穿孔一期手術中的應用. 中華臨床醫師雜志(電子版), 2012, 6(10): 2801-2802.
26. 孫寶書. 結腸一期切除帶蒂漿肌層片覆蓋吻合口預防腸瘺. 中華普通外科雜志, 2000, 15(2): 74.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following radical resection of rectal cancer

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