Application of PST technique in preventing anastomotic leakage after rectal cancer surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

PAN Jianjiang , ZHANG Yan , QIAN Shanshan ,  CHI Zhaocheng

Department of Gastrointestinal and Abdominal Tumor Surgery, Jilin Cancer Hospital, Changchun 130012, P. R. China;

Corresponding?author：

CHI Zhaocheng, Email: 20566958@qq.com

Keywords：

rectal cancer; anastomotic leakage; preservation of the left colic artery; suture of anastomotic stoma and closure of pelvic floor peritoneum; indwelling anal canal

DOI：

10.7507/1007-9424.202406003

Video：

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Objective To investigate the application value and research progress of PST technique in preventing anastomotic leakage after rectal cancer surgery. Method The related literatures at home and abroad in recent years about the application of left colon artery preservation, suture of anastomotic stoma and closure of pelvic floor peritoneum, and indwelling anal canal （PST technology for short） in rectal cancer surgery were searched and summarized. Results PST technology could prevent anastomotic leakage after rectal cancer surgery from many angles, reduce infection and inflammation, promote postoperative rehabilitation and improve the quality of life of patients, and it is simple and easy to do. The great advantages of PST technology are gradually verified and recognized in clinic. Conclusion PST is a safe and feasible method to prevent anastomotic leakage and relieve the symptoms of anastomotic leakage.

Citation： PAN Jianjiang, ZHANG Yan, QIAN Shanshan, CHI Zhaocheng. Application of PST technique in preventing anastomotic leakage after rectal cancer surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(11): 1406-1410. doi: 10.7507/1007-9424.202406003 Copy

1.	Zhang B, Zhuo GZ, Zhao K, et al. Cumulative incidence and risk factors of permanent stoma after intersphincteric resection for ultralow rectal cancer. Dis Colon Rectum, 2022, 65(1): 66-75.
2.	Chiarello MM, Fransvea P, Cariati M, et al. Anastomotic leakage in colorectal cancer surgery. Surg Oncol, 2022, 40: 101708. doi: 10.1016/j.suronc.2022.101708.
3.	徐曉佳, 王昕, 黃平. 低位直腸癌術后吻合口相關并發癥的治療及改良Bacon術再保肛的要點. 中國普通外科雜志, 2024, 33(4): 553-560.
4.	王朝樣, 林浩, 張海寶, 等. 腸道菌群對結直腸癌術后吻合口漏影響的研究進展. 中國普外基礎與臨床雜志, 2022, 29(11): 1522-1527.
5.	Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery, 2010, 147(3): 339-351.
6.	康志勇, 姜昌鎬. 結直腸癌術后吻合口漏的相關因素及預防研究進展. 中國普外基礎與臨床雜志, 2020, 27(11): 1450-1456.
7.	余向南, 付達安, 戴拯, 等. 直腸癌前切除術吻合口漏預防及治療. 中華普外科手術學雜志(電子版), 2021, 15(5): 587-590.
8.	吳云樺, 陳華, 劉棟, 等. 腹腔鏡下中低位直腸癌根治術中吻合口加固縫合預防術后吻合口瘺的效果及對術后恢復的影響. 現代腫瘤醫學, 2022, 30(23): 4274-4276.
9.	Kanemitsu Y, Hirai T, Komori K, et al. Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery. Br J Surg, 2006, 93(5): 609-615.
10.	李俊蒙, 尹瑤, 張超, 等. 3D腹腔鏡下經自然腔道取標本直腸癌根治術中保留左結腸動脈的效果觀察. 中華實用診斷與治療雜志, 2023, 37(6): 583-586.
11.	姜慧員, 劉海義, 江波, 等. 保留左結腸動脈在腹腔鏡直腸癌前切除術中的臨床應用和療效觀察. 中華結直腸疾病電子雜志, 2021, 10(1): 70-75.
12.	Zheng S, Cao M, Zheng H, et al. Bacteriological and oncological safety of complete laparoscopic radical resection of colorectal cancer without incision anastomosis based on propensity-matched scores. Wideochir Inne Tech Maloinwazyjne, 2023, 18(1): 135-143.
13.	邱小原, 昀昊, 林國樂, 等. 直腸癌新輔助放化療后根治術行保護性橫結腸造口與回腸造口對吻合口漏預防的相關研究. 中華胃腸外科雜志, 2021, 24(6): 523-529.
14.	Kinugasa T, Nagasu S, Murotani K, et al. Analysis of risk factors for anastomotic leakage after lower rectal Cancer resection, including drain type: a retrospective single-center study. BMC Gastroenterol, 2020, 20(1): 315. doi: 10.1186/s12876-020-01462-1.
15.	金從穩, 王勇, 傅贊. 吻合口加固縫合預防腹腔鏡中低位直腸癌前切除術后吻合口漏的臨床研究. 徐州醫科大學學報, 2022, 42(2): 110-114.
16.	駱洋, 俞旻皓, 陳建軍, 等. 倒刺縫線在腹腔鏡直腸癌根治術中加固吻合口的應用價值. 中華消化外科雜志, 2020, 19(11): 1205-1210.
17.	蔣天宇, 劉海山, 馬君俊, 等. 腹腔鏡直腸雙吻合術吻合口不同加固方式對吻合口漏的影響. 上海交通大學學報(醫學版), 2020, 40(7): 951-956, 950.
18.	孫生安, 李朝輝, 張彥, 等. 保留左結腸動脈聯合留置肛管在預防低位直腸癌術后吻合口漏中的效果評價. 臨床研究, 2021, 29(8): 34-35.
19.	羅迦耀, 方祀福, 賴建勤, 等. 盆底腹膜重建聯合肛管引流在預防腹腔鏡直腸癌前切除術后吻合口漏的應用. 嶺南現代臨床外科, 2020, 20(1): 8-11.
20.	Nishigori H, Ito M, Nishizawa Y. A novel transanal tube designed to prevent anastomotic leakage after rectal cancer surgery: the WING DRAIN. Surg Today, 2017, 47(4): 513-520.
21.	楊亞鵬, 張雪民, 張新偉, 等. 直腸癌低位前切除術后發生吻合口漏的影響因素分析. 中國肛腸病雜志, 2022, 42(6): 1-3.
22.	汪雪, 王夢橋, 劉建, 等. 直腸癌腹腔鏡手術中關閉盆底腹膜對術后早期機械性腸梗阻發生的影響及其相關危險因素分析. 實用癌癥雜志, 2018, 33(9): 1452-1454.
23.	劉云庚, 張磊, 黃箕然, 等. 腹腔鏡下直腸前切除術中保留左結腸動脈對促進患者術后的康復作用. 南方醫科大學學報, 2017, 37(9): 1261-1264.
24.	張金強, 李文斌. 腹腔鏡直腸癌根治術中保留左結腸動脈對直腸癌患者胃腸功能、免疫系統及遠期預后的影響. 貴州醫藥, 2023, 47(5): 705-707.
25.	Campbell A, Macdonald A, Oliphant R, et al. Neurovasculature of high and low tie ligation of the inferior mesenteric artery. Surg Radiol Anat, 2018, 40(12): 1343-1348.
26.	付正偉, 王麗霞, 張振宇, 等. 盆底腹膜重建在3D腹腔鏡輔助直腸前切除術中的價值. 中華腔鏡外科雜志(電子版), 2018, 11(2): 94-97.
27.	周之偉, 王亮, 楊劍逸, 等. 吻合口加固縫合對食管癌根治術后吻合口瘺發生的預防效果. 中華臨床醫師雜志(電子版), 2021, 15(6): 407-411.
28.	李泳, 程龍慶. 留置肛管對預防直腸癌低位保肛術后吻合口漏的療效觀察. 黑龍江中醫藥, 2019, 48(3): 53-54.
29.	李偉, 國瑀辰, 所劍. 腹腔鏡下保留左結腸動脈的直腸癌D3根治術的爭議與體會. 中國普外基礎與臨床雜志, 2019, 26(8): 912-916.
30.	邢宏彬, 張國強, 李高峰. 腹腔鏡超低位直腸癌保肛術中經肛加固縫合吻合口的安全性可行性研究. 中國肛腸病雜志, 2023, 43(5): 16-18.
31.	班搏. 留置肛管在腹腔鏡中低位直腸癌保肛術中的應用. 吉林大學, 2022.
32.	閆亞敏, 陸晶晶, 虞正紅, 等. 結直腸癌術后留置肛管管理方案的構建與應用研究. 護士進修雜志, 2023, 38(20): 1835-1841.

1. Zhang B, Zhuo GZ, Zhao K, et al. Cumulative incidence and risk factors of permanent stoma after intersphincteric resection for ultralow rectal cancer. Dis Colon Rectum, 2022, 65(1): 66-75.
2. Chiarello MM, Fransvea P, Cariati M, et al. Anastomotic leakage in colorectal cancer surgery. Surg Oncol, 2022, 40: 101708. doi: 10.1016/j.suronc.2022.101708.
3. 徐曉佳, 王昕, 黃平. 低位直腸癌術后吻合口相關并發癥的治療及改良Bacon術再保肛的要點. 中國普通外科雜志, 2024, 33(4): 553-560.
4. 王朝樣, 林浩, 張海寶, 等. 腸道菌群對結直腸癌術后吻合口漏影響的研究進展. 中國普外基礎與臨床雜志, 2022, 29(11): 1522-1527.
5. Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery, 2010, 147(3): 339-351.
6. 康志勇, 姜昌鎬. 結直腸癌術后吻合口漏的相關因素及預防研究進展. 中國普外基礎與臨床雜志, 2020, 27(11): 1450-1456.
7. 余向南, 付達安, 戴拯, 等. 直腸癌前切除術吻合口漏預防及治療. 中華普外科手術學雜志(電子版), 2021, 15(5): 587-590.
8. 吳云樺, 陳華, 劉棟, 等. 腹腔鏡下中低位直腸癌根治術中吻合口加固縫合預防術后吻合口瘺的效果及對術后恢復的影響. 現代腫瘤醫學, 2022, 30(23): 4274-4276.
9. Kanemitsu Y, Hirai T, Komori K, et al. Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery. Br J Surg, 2006, 93(5): 609-615.
10. 李俊蒙, 尹瑤, 張超, 等. 3D腹腔鏡下經自然腔道取標本直腸癌根治術中保留左結腸動脈的效果觀察. 中華實用診斷與治療雜志, 2023, 37(6): 583-586.
11. 姜慧員, 劉海義, 江波, 等. 保留左結腸動脈在腹腔鏡直腸癌前切除術中的臨床應用和療效觀察. 中華結直腸疾病電子雜志, 2021, 10(1): 70-75.
12. Zheng S, Cao M, Zheng H, et al. Bacteriological and oncological safety of complete laparoscopic radical resection of colorectal cancer without incision anastomosis based on propensity-matched scores. Wideochir Inne Tech Maloinwazyjne, 2023, 18(1): 135-143.
13. 邱小原, 昀昊, 林國樂, 等. 直腸癌新輔助放化療后根治術行保護性橫結腸造口與回腸造口對吻合口漏預防的相關研究. 中華胃腸外科雜志, 2021, 24(6): 523-529.
14. Kinugasa T, Nagasu S, Murotani K, et al. Analysis of risk factors for anastomotic leakage after lower rectal Cancer resection, including drain type: a retrospective single-center study. BMC Gastroenterol, 2020, 20(1): 315. doi: 10.1186/s12876-020-01462-1.
15. 金從穩, 王勇, 傅贊. 吻合口加固縫合預防腹腔鏡中低位直腸癌前切除術后吻合口漏的臨床研究. 徐州醫科大學學報, 2022, 42(2): 110-114.
16. 駱洋, 俞旻皓, 陳建軍, 等. 倒刺縫線在腹腔鏡直腸癌根治術中加固吻合口的應用價值. 中華消化外科雜志, 2020, 19(11): 1205-1210.
17. 蔣天宇, 劉海山, 馬君俊, 等. 腹腔鏡直腸雙吻合術吻合口不同加固方式對吻合口漏的影響. 上海交通大學學報(醫學版), 2020, 40(7): 951-956, 950.
18. 孫生安, 李朝輝, 張彥, 等. 保留左結腸動脈聯合留置肛管在預防低位直腸癌術后吻合口漏中的效果評價. 臨床研究, 2021, 29(8): 34-35.
19. 羅迦耀, 方祀福, 賴建勤, 等. 盆底腹膜重建聯合肛管引流在預防腹腔鏡直腸癌前切除術后吻合口漏的應用. 嶺南現代臨床外科, 2020, 20(1): 8-11.
20. Nishigori H, Ito M, Nishizawa Y. A novel transanal tube designed to prevent anastomotic leakage after rectal cancer surgery: the WING DRAIN. Surg Today, 2017, 47(4): 513-520.
21. 楊亞鵬, 張雪民, 張新偉, 等. 直腸癌低位前切除術后發生吻合口漏的影響因素分析. 中國肛腸病雜志, 2022, 42(6): 1-3.
22. 汪雪, 王夢橋, 劉建, 等. 直腸癌腹腔鏡手術中關閉盆底腹膜對術后早期機械性腸梗阻發生的影響及其相關危險因素分析. 實用癌癥雜志, 2018, 33(9): 1452-1454.
23. 劉云庚, 張磊, 黃箕然, 等. 腹腔鏡下直腸前切除術中保留左結腸動脈對促進患者術后的康復作用. 南方醫科大學學報, 2017, 37(9): 1261-1264.
24. 張金強, 李文斌. 腹腔鏡直腸癌根治術中保留左結腸動脈對直腸癌患者胃腸功能、免疫系統及遠期預后的影響. 貴州醫藥, 2023, 47(5): 705-707.
25. Campbell A, Macdonald A, Oliphant R, et al. Neurovasculature of high and low tie ligation of the inferior mesenteric artery. Surg Radiol Anat, 2018, 40(12): 1343-1348.
26. 付正偉, 王麗霞, 張振宇, 等. 盆底腹膜重建在3D腹腔鏡輔助直腸前切除術中的價值. 中華腔鏡外科雜志(電子版), 2018, 11(2): 94-97.
27. 周之偉, 王亮, 楊劍逸, 等. 吻合口加固縫合對食管癌根治術后吻合口瘺發生的預防效果. 中華臨床醫師雜志(電子版), 2021, 15(6): 407-411.
28. 李泳, 程龍慶. 留置肛管對預防直腸癌低位保肛術后吻合口漏的療效觀察. 黑龍江中醫藥, 2019, 48(3): 53-54.
29. 李偉, 國瑀辰, 所劍. 腹腔鏡下保留左結腸動脈的直腸癌D3根治術的爭議與體會. 中國普外基礎與臨床雜志, 2019, 26(8): 912-916.
30. 邢宏彬, 張國強, 李高峰. 腹腔鏡超低位直腸癌保肛術中經肛加固縫合吻合口的安全性可行性研究. 中國肛腸病雜志, 2023, 43(5): 16-18.
31. 班搏. 留置肛管在腹腔鏡中低位直腸癌保肛術中的應用. 吉林大學, 2022.
32. 閆亞敏, 陸晶晶, 虞正紅, 等. 結直腸癌術后留置肛管管理方案的構建與應用研究. 護士進修雜志, 2023, 38(20): 1835-1841.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of PST technique in preventing anastomotic leakage after rectal cancer surgery

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