Effect of different reinforcement methods on anastomotic leakage after laparoscopic double stapled technique / 上海交通大学学报（医学版）

ABSTRACT

Objective: To investigate the effect of different suture reinforcement methods on anastomotic leakage (AL) after laparoscopic double stapled technique (DST). Methods: Data were collected from patients undergoing laparoscopic radical resection of colon-rectal cancer from July 2017 to September 2018 in the Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai Minimally Invasive Surgery Center). Patients were divided into 3 groups according to the different ways of suture reinforcement: intermittent suture reinforcement group (n=41), continuous suture reinforcement group (n=41) and non-reinforcement group (control group, n=41). The intraoperative and postoperative conditions of the three groups were compared. One-way ANOVA, χ2 test, Fisher's test and non-parametric test were used for statistical analysis. Results: A total of 124 patients were included in this study. There were no statistically significant differences in operation time, intraoperative blood loss, postoperative hospital stay, postoperative gastrointestinal exhaust time and postoperative fluid intake time of two experimental groups compared with control group. Nine subjects were clinically diagnosed with anastomotic leakage. The incidences of serious AL of intermittent suture reinforcement group and continuous suture reinforcement group were lower than that in the control group. The average length of stay in patients with AL in the intermittent suture reinforcement group was 31 (19-42) d, and the continuous suture reinforcement group was 41 (37-43) d, which were significantly lower when compared with the control group of 64 (54-74) d. In addition, the average treatment cost of the intermittent suture reinforcement group was (71 142.6±2 849.3) yuan, and the continuous suture reinforcement group was (71 360.1±2 072.3) yuan, which were significantly lower than the control group of (91 386.0±9 151.7) yuan. Conclusion: Laparoscopic DST using intermittent suture and continuous suture can reduce the incidence of serious AL, shorten the length of hospital stay and reduce the cost of treatment without increasing the difficulty of surgery and other postoperative complications.