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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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.	刘德忠. 直肠癌保肛术后吻合口漏的危险因素分析. 中国医学创新, 2014, 11(10): 25-27.
2.	陈万青, 郑荣寿, 张思维. 2012年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2016, 25(1): 1-8.
3.	吴在德, 吴孟超. 黄家驷外科学. 第7版. 北京: 人民卫生出版社, 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.	张卫, 朱晓明. 低位直肠癌保肛术后功能与疗效评价. 中国实用外科杂志, 2017, 37(6): 624-628.
6.	卫星, 宋卫东. 中低位直肠癌 TME 保肛术后吻合口瘘原因分析及防治. 内蒙古医学杂志, 2014, 47(2): 208-209.
7.	池畔, 陈致奋. 直肠癌术后吻合口漏的诊断与治疗进展. 中华消化外科杂志, 2014, 13(7): 584-590.
8.	彭昌兵, 庄文. 低位直肠癌保肛术后吻合口漏的原因及防治现状. 中国普外基础与临床杂志, 2014, 21(2) : 251-255.
9.	傅传刚, 郝立强. 低位直肠癌保肛术后吻合口漏与狭窄原因及治疗. 中国实用外科杂志, 2014, 34(9): 851-854.
10.	王炳举, 刘彬, 孙成岗, 等. 直肠癌全系膜切除术后吻合口漏的危险因素分析. 中国肿瘤临床与康复, 2014, 21(3): 270-271.
11.	戎祯祥, 蔡恒烈, 赵欣. 腹腔镜直肠癌根治术前 MSCT 血管三维重建Riolan弓的临床价值. 广东医学, 2015, 36(10): 1528-1530.
12.	渠浩, 杜燕夫, 李敏哲, 等. 腹腔镜直肠乙状结肠手术中近端肠管血运障碍的原因分析(附17例报告). 中国微创外科杂志, 2014, 14(5): 458-460.
13.	李建业, 李国宾, 耿强, 等. 高龄结直肠癌患者开放根治性手术并发症及其影响因素分析. 中国普外基础与临床杂志, 2015, 22(4): 460-463.
14.	孔杰, 甘从存, 徐士杰, 等. 中低位直肠癌全直肠系膜切除术后吻合口瘘的危险素分析. 中国普外基础与临床杂志, 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•吾守尔, 等. 可预防性造口在直肠癌低位前切除术中的应用价值. 医学综述, 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.	张庭澍, 罗蓬, 曹云, 等. 带蒂大网膜覆盖一期修补治疗结肠损伤体会. 结直肠肛门外科, 2006, 12(5): 307.
19.	尚培中, 张振海, 刘绪友, 等. 带血管蒂回肠浆肌瓣预防回结肠吻合口漏. 中国普外基础与临床杂志, 2000, 7(1): 51.
20.	陈乾德, 陈汉卿. " 带蒂回肠袖带”在直肠癌手术中的应用. 中国现代医生, 2008, 46(35): 53-55.
21.	丁原淑, 王和厚, 陈晓玲, 等. 肠袢袖套加强吻合口法治疗老年梗阻性左半结肠癌. 齐鲁肿瘤杂志, 1998, 5(2): 149.
22.	陈乾德, 陈汉卿, 韩飞. 带蒂袖状结肠在直肠癌前切除手术中的应用研究. 中华普外科手术学杂志(电子版), 2015, 9(3): 188-191.
23.	沈荐, 李敏哲, 杜燕夫, 等. 腹腔镜直肠癌前切除术中保留左结肠动脉与否的临床对照研究. 中国微创外科杂志, 2014, 14(1): 22-24, 28.
24.	严小贵, 钱永坤, 蒋新卫. 腹腔镜直肠癌根治术62例应用体会. 中国普外基础与临床杂志, 2015, 22(5): 554.
25.	杨建国, 李正平, 王志刚, 等. 浆肌瓣隧道式肠吻合在急性左半结肠穿孔一期手术中的应用. 中华临床医师杂志(电子版), 2012, 6(10): 2801-2802.
26.	孙宝书. 结肠一期切除带蒂浆肌层片覆盖吻合口预防肠瘘. 中华普通外科杂志, 2000, 15(2): 74.

1. 刘德忠. 直肠癌保肛术后吻合口漏的危险因素分析. 中国医学创新, 2014, 11(10): 25-27.
2. 陈万青, 郑荣寿, 张思维. 2012年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2016, 25(1): 1-8.
3. 吴在德, 吴孟超. 黄家驷外科学. 第7版. 北京: 人民卫生出版社, 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. 张卫, 朱晓明. 低位直肠癌保肛术后功能与疗效评价. 中国实用外科杂志, 2017, 37(6): 624-628.
6. 卫星, 宋卫东. 中低位直肠癌 TME 保肛术后吻合口瘘原因分析及防治. 内蒙古医学杂志, 2014, 47(2): 208-209.
7. 池畔, 陈致奋. 直肠癌术后吻合口漏的诊断与治疗进展. 中华消化外科杂志, 2014, 13(7): 584-590.
8. 彭昌兵, 庄文. 低位直肠癌保肛术后吻合口漏的原因及防治现状. 中国普外基础与临床杂志, 2014, 21(2) : 251-255.
9. 傅传刚, 郝立强. 低位直肠癌保肛术后吻合口漏与狭窄原因及治疗. 中国实用外科杂志, 2014, 34(9): 851-854.
10. 王炳举, 刘彬, 孙成岗, 等. 直肠癌全系膜切除术后吻合口漏的危险因素分析. 中国肿瘤临床与康复, 2014, 21(3): 270-271.
11. 戎祯祥, 蔡恒烈, 赵欣. 腹腔镜直肠癌根治术前 MSCT 血管三维重建Riolan弓的临床价值. 广东医学, 2015, 36(10): 1528-1530.
12. 渠浩, 杜燕夫, 李敏哲, 等. 腹腔镜直肠乙状结肠手术中近端肠管血运障碍的原因分析(附17例报告). 中国微创外科杂志, 2014, 14(5): 458-460.
13. 李建业, 李国宾, 耿强, 等. 高龄结直肠癌患者开放根治性手术并发症及其影响因素分析. 中国普外基础与临床杂志, 2015, 22(4): 460-463.
14. 孔杰, 甘从存, 徐士杰, 等. 中低位直肠癌全直肠系膜切除术后吻合口瘘的危险素分析. 中国普外基础与临床杂志, 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•吾守尔, 等. 可预防性造口在直肠癌低位前切除术中的应用价值. 医学综述, 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. 张庭澍, 罗蓬, 曹云, 等. 带蒂大网膜覆盖一期修补治疗结肠损伤体会. 结直肠肛门外科, 2006, 12(5): 307.
19. 尚培中, 张振海, 刘绪友, 等. 带血管蒂回肠浆肌瓣预防回结肠吻合口漏. 中国普外基础与临床杂志, 2000, 7(1): 51.
20. 陈乾德, 陈汉卿. " 带蒂回肠袖带”在直肠癌手术中的应用. 中国现代医生, 2008, 46(35): 53-55.
21. 丁原淑, 王和厚, 陈晓玲, 等. 肠袢袖套加强吻合口法治疗老年梗阻性左半结肠癌. 齐鲁肿瘤杂志, 1998, 5(2): 149.
22. 陈乾德, 陈汉卿, 韩飞. 带蒂袖状结肠在直肠癌前切除手术中的应用研究. 中华普外科手术学杂志(电子版), 2015, 9(3): 188-191.
23. 沈荐, 李敏哲, 杜燕夫, 等. 腹腔镜直肠癌前切除术中保留左结肠动脉与否的临床对照研究. 中国微创外科杂志, 2014, 14(1): 22-24, 28.
24. 严小贵, 钱永坤, 蒋新卫. 腹腔镜直肠癌根治术62例应用体会. 中国普外基础与临床杂志, 2015, 22(5): 554.
25. 杨建国, 李正平, 王志刚, 等. 浆肌瓣隧道式肠吻合在急性左半结肠穿孔一期手术中的应用. 中华临床医师杂志(电子版), 2012, 6(10): 2801-2802.
26. 孙宝书. 结肠一期切除带蒂浆肌层片覆盖吻合口预防肠瘘. 中华普通外科杂志, 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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