外科理论与实践 ›› 2022, Vol. 27 ›› Issue (03): 261-265.doi: 10.16139/j.1007-9610.2022.03.016
收稿日期:
2021-02-25
出版日期:
2022-06-25
发布日期:
2022-08-03
基金资助:
FU Zhanwei, MA Junjun, ZHENG Minhua()
Received:
2021-02-25
Online:
2022-06-25
Published:
2022-08-03
摘要:
直肠癌是常见的消化系统恶性肿瘤。直肠癌手术治疗效果受到病人的盆腔解剖特点的影响。盆腔空间狭小增加手术操作难度,还增加吻合口漏等术后并发症的发生率。本文综述盆腔解剖特点影响直肠癌手术难度及术后吻合口漏发生的危险因素。
中图分类号:
付占威 综述, 马君俊, 郑民华 审校. 盆腔解剖学特点对直肠癌手术及术后吻合口漏发生的影响[J]. 外科理论与实践, 2022, 27(03): 261-265.
FU Zhanwei, MA Junjun, ZHENG Minhua. Impact of pelvic anatomical features on rectal cancer surgery and postoperative anastomotic leakage[J]. Journal of Surgery Concepts & Practice, 2022, 27(03): 261-265.
[1] |
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6):394-424.
doi: 10.3322/caac.21492 URL |
[2] |
Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132.
doi: 10.3322/caac.21338 URL |
[3] |
Hida K, Okamura R, Sakai Y, et al. Open versus laparoscopic surgery for advanced low rectal cancer: a large, multicenter, propensity score matched cohort study in Japan[J]. Ann Surg, 2018, 268(2):318-324.
doi: 10.1097/SLA.0000000000002329 URL |
[4] |
Martínez-Pérez A, Carra MC, Brunetti F, et al. Pathologic outcomes of laparoscopic vs open mesorectal excision for rectal cancer: a systematic review and meta-analysis[J]. JAMA surg, 2017, 152(4):e165665.
doi: 10.1001/jamasurg.2016.5665 URL |
[5] |
Roxburgh CS, Guillem JG. Outcomes of open vs laparoscopic rectal cancer resection[J]. JAMA Oncol, 2017, 3(1):115-116.
doi: 10.1001/jamaoncol.2016.3205 URL |
[6] |
MacFarlane JK, Ryall RD, Heald RJ. Mesorectal excision for rectal cancer[J]. Lancet, 1993, 341(8843):457-460.
pmid: 8094488 |
[7] |
Curtis NJ, Thomas C, Dennison G, et al. Factors predic-ting operative difficulty of laparoscopic total mesorectal excision[J]. Dis Colon Rectum, 2019, 62(12):1467-1476.
doi: 10.1097/DCR.0000000000001490 URL |
[8] |
Chau J, Solomon J, Liberman AS, et al. Pelvic dimensions on preoperative imaging can identify poor-quality resections after laparoscopic low anterior resection for mid- and low rectal cancer[J]. Surg Endosc, 2020, 34(10):4609-4615.
doi: 10.1007/s00464-019-07209-8 URL |
[9] |
Leonard D, Penninckx F, Fieuws S, et al. Factors predic-ting the quality of total mesorectal excision for rectal cancer[J]. Ann Surg, 2010, 252(6):982-988.
doi: 10.1097/SLA.0b013e3181efc142 pmid: 21107108 |
[10] |
Moore HG. Importance of the circumferential resection margin[J]. J Am Coll Surg, 2020, 230(6):1018-1019.
doi: 10.1016/j.jamcollsurg.2020.03.021 URL |
[11] |
Kang CY, Halabi WJ, Chaudhry OO, et al. Risk factors for anastomotic leakage after anterior resection for rectal cancer[J]. JAMA Surg, 2013, 148(1):65-71.
doi: 10.1001/2013.jamasurg.2 URL |
[12] |
Park JS, Choi GS, Kim SH, et al. Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision: the Korean Laparoscopic Colorectal Surgery Study Group[J]. Ann Surg, 2013, 257(4):665-671.
doi: 10.1097/SLA.0b013e31827b8ed9 URL |
[13] |
Borstlap WAA, Westerduin E, Aukema TS, et al. Anastomotic leakage and chronic presacral sinus formation after low anterior resection: results from a large cross-sectional study[J]. Ann Surg, 2017, 266(5):870-877.
doi: 10.1097/SLA.0000000000002429 pmid: 28746154 |
[14] | 蒋天宇, 孙晶, 郑民华. 腹腔镜直肠癌低位前切除术后吻合口漏的影响因素分析[J]. 外科理论与实践, 2019, 24(2):171-174. |
[15] | Koedam TWA, Bootsma BT, Deijen CL, et al. Oncological outcomes after anastomotic leakage after surgery for colon or rectal cancer: increased risk of local recurrence[J]. Ann Surg, 2022, 275(2):e420-e427. |
[16] |
Kverneng Hultberg D, Svensson J, Jutesten H, et al. The impact of anastomotic leakage on long-term function after anterior resection for rectal cancer[J]. Dis Colon Rectum, 2020, 63(5):619-628.
doi: 10.1097/DCR.0000000000001613 pmid: 32032197 |
[17] |
Verschueren RC, Mulder NH, van Loon AJ, et al. The anatomical substrate for a difference in surgical approach to rectal cancer in male and female patients[J]. Anticancer Res, 1997, 17(1B):637-641.
pmid: 9066593 |
[18] |
Veenhof AA, Engel AF, van der Peet DL, et al. Technical difficulty grade score for the laparoscopic approach of rectal cancer: a single institution pilot study[J]. Int J Colorectal Dis, 2008, 23(5):469-475.
doi: 10.1007/s00384-007-0433-5 pmid: 18185936 |
[19] |
Baik SH, Kim NK, Lee KY, et al. Factors influencing pathologic results after total mesorectal excision for rectal cancer: analysis of consecutive 100 cases[J]. Ann Surg Oncol, 2008, 15(3):721-728.
doi: 10.1245/s10434-007-9706-z URL |
[20] |
Zhou XC, Su M, Hu KQ, et al. CT pelvimetry and clinicopathological parameters in evaluation of the technical difficulties in performing open rectal surgery for mid-low rectal cancer[J]. Oncol Lett, 2016, 11(1):31-38.
doi: 10.3892/ol.2015.3827 URL |
[21] |
Killeen T, Banerjee S, Vijay V, et al. Magnetic resonance (MR) pelvimetry as a predictor of difficulty in laparoscopic operations for rectal cancer[J]. Surg Endosc, 2010, 24(12):2974-2979.
doi: 10.1007/s00464-010-1075-1 pmid: 20464426 |
[22] |
Boyle KM, Petty D, Chalmers AG, et al. MRI assessment of the bony pelvis may help predict resectability of rectal cancer[J]. Colorectal Dis, 2005, 7(3):232-240.
pmid: 15859960 |
[23] |
Parthasarathy M, Greensmith M, Bowers D, et al. Risk factors for anastomotic leakage after colorectal resection: a retrospective analysis of 17 518 patients[J]. Colorectal Dis, 2017, 19(3):288-298.
doi: 10.1111/codi.13476 pmid: 27474844 |
[24] | Bertani E, Chiappa A, Della Vigna P, et al. The Impact of pelvimetry on anastomotic leakage in a consecutive series of open, laparoscopic and robotic low anterior resections with total mesorectal excision for rectal cancer[J]. Hepatogastroenterology, 2014, 61(134):1574-1581. |
[25] |
Benson AB, Venook AP, Al-Hawary MM, et al. Rectal cancer, version 2.2018, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw,2018, 16(7):874-901.
doi: 10.6004/jnccn.2018.0061 URL |
[26] |
Pai RK, Pai RK. Pathologic assessment of gastrointestinal tract and pancreatic carcinoma after neoadjuvant therapy[J]. Mod Pathol, 2018, 31(1):4-23.
doi: 10.1038/modpathol.2017.87 URL |
[27] | Sourati A, Ameri A, Malekzadeh M. Acute Side Effects of Radiation Therapy[M]. Springer International Publishing, 2017. |
[28] | 杨昆, 张维汉, 陈心足, 等. 新辅助治疗大体组织反应评级体系的建立和初步应用[J]. 中华胃肠外科杂志, 2018, 21(9):1032-1038. |
[29] |
Akiyoshi T, Kuroyanagi H, Oya M, et al. Factors affec-ting the difficulty of laparoscopic total mesorectal excision with double stapling technique anastomosis for low rectal cancer[J]. Surgery, 2009, 146(3):483-489.
doi: 10.1016/j.surg.2009.03.030 URL |
[30] |
Rombouts AJM, Hugen N, Elferink MAG, et al. Treatment interval between neoadjuvant chemoradiotherapy and surgery in rectal cancer patients: a population-based study[J]. Ann Surg Oncol, 2016, 23(11):3593-3601.
doi: 10.1245/s10434-016-5294-0 pmid: 27251135 |
[31] |
Du D, Su Z, Wang D, et al. Optimal interval to surgery after neoadjuvant chemoradiotherapy in rectal cancer: a systematic review and meta-analysis[J]. Clin Colorectal Cancer, 2018, 17(1):13-24.
doi: 10.1016/j.clcc.2017.10.012 URL |
[32] |
Lefèvre JH, Mineur L, Cachanado M, et al. Does a longer waiting period after neoadjuvant radio-chemotherapy improve the oncological prognosis of rectal cancer? Three years′ follow-up results of the greccar-6 randomized multicenter trial[J]. Ann Surg, 2019, 270(5):747-754.
doi: 10.1097/SLA.0000000000003530 URL |
[33] |
Ogiso S, Yamaguchi T, Hata H, et al. Evaluation of factors affecting the difficulty of laparoscopic anterior resection for rectal cancer: “narrow pelvis” is not a contraindication[J]. Surg Endosc, 2011, 25(6):1907-1912.
doi: 10.1007/s00464-010-1485-0 URL |
[34] |
Seki Y, Ohue M, Sekimoto m, et al. Evaluation of the technical difficulty performing laparoscopic resection of a rectosigmoid carcinoma: visceral fat reflects technical difficulty more accurately than body mass index[J]. Surg Endosc, 2007, 21(6):929-934.
pmid: 17285393 |
[35] |
Qin Q, Ma T, Deng Y, et al. Impact of preoperative radiotherapy on anastomotic leakage and stenosis after rectal cancer resection: post hoc analysis of a randomized controlled trial[J]. Dis Colon Rectum, 2016, 59(10):934-942.
doi: 10.1097/DCR.0000000000000665 URL |
[36] |
Ansari N, Solomon MJ, Fisher RJ, et al. Acute adverse events and postoperative complications in a randomized trial of preoperative short-course radiotherapy versus long-course chemoradiotherapy for T3 adenocarcinoma of the rectum: trans-tasman radiation oncology group trial (TROG 01.04)[J]. Ann Surg, 2017, 265(5):882-888.
doi: 10.1097/SLA.0000000000001987 URL |
[37] |
Sung SY, Jang HS, Kim SH, et al. Oncologic outcome and morbidity in the elderly rectal cancer patients after preoperative chemoradiotherapy and total mesorectal excision: a multi-institutional and case-matched control study[J]. Ann Surg, 2019, 269(1):108-113.
doi: 10.1097/SLA.0000000000002443 URL |
[38] |
Griffen FD, Knight CD Sr, Whitaker JM, et al. The double stapling technique for low anterior resection. results, modifications, and observations[J]. Ann Surg, 1990, 211(6):745-751;discussion 751-752.
pmid: 2357137 |
[39] |
Ito M, Sugito M, Kobayashi A, et al. Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection[J]. Int J Colorectal Dis, 2008, 23(7):703-707.
doi: 10.1007/s00384-008-0470-8 URL |
[40] |
Balciscueta Z, Uribe N, Caubet L, et al. Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis[J]. Tech Coloproctol, 2020, 24(9):919-925.
doi: 10.1007/s10151-020-02240-7 pmid: 32451807 |
[41] |
Arezzo A, Migliore M, Chiaro P, et al. The REAL (REctal Anastomotic Leak) score for prediction of anastomotic leak after rectal cancer surgery[J]. Tech Coloproctol, 2019, 23(7):649-663.
doi: 10.1007/s10151-019-02028-4 pmid: 31240416 |
[42] | Zhang W, Lou Z, Liu Q, et al. Multicenter analysis of risk factors for anastomotic leakage after middle and low rectal cancer resection without diverting stoma: a retrospective study of 319 consecutive patients[J]. Int J Co-lorectal Dis, 2017, 32(10):1431-1437. |
[43] |
Qu H, Liu Y, Bi DS. Clinical risk factors for anastomotic leakage after laparoscopic anterior resection for rectal cancer: a systematic review and meta-analysis[J]. Surg Endosc, 2015, 29(12):3608-3617.
doi: 10.1007/s00464-015-4117-x URL |
[44] |
Balyasnikova S, Brown G. Optimal imaging strategies for rectal cancer staging and ongoing management[J]. Curr Treat Options Oncol, 2016, 17(6):32.
doi: 10.1007/s11864-016-0403-7 URL |
[45] |
Kennedy ED, Simunovic M, Jhaveri K, et al. Safety and feasibility of using magnetic resonance imaging criteria to identify patients with “good prognosis” rectal cancer eligible for primary surgery: the phase 2 nonrandomized quicksilver clinical trial[J]. JAMA oncol, 2019, 5(7):961-966.
doi: 10.1001/jamaoncol.2019.0186 pmid: 30973610 |
[46] | 中华医学会外科学分会结直肠外科学组, 中华医学会外科学分会腹腔镜与内镜外科学组. 直肠癌经肛全直肠系膜切除专家共识及手术操作指南(2017版)[J]. 中国实用外科杂志, 2017, 37(9):978-984. |
[47] | 张旋, 高屹, 代行龙, 等. 腹腔镜辅助经肛门全直肠系膜切除术与腹腔镜全直肠系膜切除术治疗中低位直肠癌近、远期疗效比较的Meta分析[J]. 中华胃肠外科杂志, 2018, 21(8):924-935. |
[48] |
Penna M, Hompes R, Arnold S, et al. Incidence and risk factors for anastomotic failure in 1594 patients treated by transanal total mesorectal excision: results from the International TaTME Registry[J]. Ann Surg, 2019, 269(4):700-711.
doi: 10.1097/SLA.0000000000002653 URL |
[49] |
Mrak K, Uranitsch S, Pedross F, et al. Diverting ileostomy versus no diversion after low anterior resection for rectal cancer: a prospective, randomized, multicenter trial[J]. Surgery, 2016, 159(4):1129-1139.
doi: 10.1016/j.surg.2015.11.006 URL |
[50] | Salamone G, Licari L, Agrusa A, et al. Usefulness of ileostomy defunctioning stoma after anterior resection of rectum on prevention of anastomotic leakage A retrospective analysis[J]. Ann Ital Chir, 2016, 87:155-160. |
[51] |
Ihnát P, Guňková P, Peteja M, et al. Diverting ileostomy in laparoscopic rectal cancer surgery: high price of protection[J]. Surg Endosc, 2016, 30(11):4809-4816.
doi: 10.1007/s00464-016-4811-3 URL |
[52] |
Cho SH, Lee IK, Lee YS, et al. The usefulness of transanal tube for reducing anastomotic leak in mid rectal cancer: compared to diverting stoma[J]. Ann Surg Treat Res, 2021, 100(2):100-108.
doi: 10.4174/astr.2021.100.2.100 URL |
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