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: 48820056@qq.com

Keywords：

rectal cancer; anastomotic leakage; preservation of the left colic artery; suturing the anastomosis and closing the 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 and reinforcement of anastomosis, 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.

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.	徐晓佳, 王昕, 黄平. 低位直肠癌术后吻合口相关并发症的治疗及改良Bacon术再保肛的要点. 中国普通外科杂志, 2024, 33(4): 553-560.
4.	王朝樣, 林浩, 张海宝, 等. 肠道菌群对结直肠癌术后吻合口漏影响的研究进展. 中国普外基础与临床杂志, 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, 姜昌镐. 结直肠癌术后吻合口漏的相关因素及预防研究进展. 中国普外基础与临床杂志, 2020, 27(11): 1450-1456.
7.	余向南, 付达安, 戴拯, 等. 直肠癌前切除术吻合口漏预防及治疗. 中华普外科手术学杂志(电子版), 2021, 15(5): 587-590.
8.	吴云桦, 陈华, 刘栋, 等. 腹腔镜下中低位直肠癌根治术中吻合口加固缝合预防术后吻合口瘘的效果及对术后恢复的影响. 现代肿瘤医学, 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, 尹瑶, 张超, 等. 3D腹腔镜下经自然腔道取标本直肠癌根治术中保留左结肠动脉的效果观察. 中华实用诊断与治疗杂志, 2023, 37(6): 583-586.
11.	姜慧员, 刘海义, 江波, 等. 保留左结肠动脉在腹腔镜直肠癌前切除术中的临床应用和疗效观察. 中华结直肠疾病电子杂志, 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, 林国乐, 等. 直肠癌新辅助放化疗后根治术行保护性横结肠造口与回肠造口对吻合口漏预防的相关研究. 中华胃肠外科杂志, 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.	金从稳, 王勇, 傅赞. 吻合口加固缝合预防腹腔镜中低位直肠癌前切除术后吻合口漏的临床研究. 徐州医科大学学报, 2022, 42(2): 110-114.
16.	骆洋, 俞旻皓, 陈建军, 等. 倒刺缝线在腹腔镜直肠癌根治术中加固吻合口的应用价值. 中华消化外科杂志, 2020, 19(11): 1205-1210.
17.	蒋天宇, 刘海山, 马君俊, 等. 腹腔镜直肠双吻合术吻合口不同加固方式对吻合口漏的影响. 上海交通大学学报(医学版), 2020, 40(7): 951-956,950.
18.	孙生安, 李朝辉, 张彦, 等. 保留左结肠动脉联合留置肛管在预防低位直肠癌术后吻合口漏中的效果评价. 临床研究, 2021, 29(8): 34-35.
19.	罗迦耀, 方祀福, 赖建勤, 等. 盆底腹膜重建联合肛管引流在预防腹腔镜直肠癌前切除术后吻合口漏的应用. 岭南现代临床外科, 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.	杨亚鹏, 张雪民, 张新伟, 等. 直肠癌低位前切除术后发生吻合口漏的影响因素分析. 中国肛肠病杂志, 2022, 42(6): 1-3.
22.	汪雪, 王梦桥, 刘建, 等. 直肠癌腹腔镜手术中关闭盆底腹膜对术后早期机械性肠梗阻发生的影响及其相关危险因素分析. 实用癌症杂志, 2018, 33(9): 1452-1454.
23.	刘云庚, 张磊, 黄箕然, 等. 腹腔镜下直肠前切除术中保留左结肠动脉对促进患者术后的康复作用. 南方医科大学学报, 2017, 37(9): 1261-1264.
24.	张金强, 李文斌. 腹腔镜直肠癌根治术中保留左结肠动脉对直肠癌患者胃肠功能、免疫系统及远期预后的影响. 贵州医药, 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.	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.
27.	付正伟, 王丽霞, 张振宇, 等. 盆底腹膜重建在3D腹腔镜辅助直肠前切除术中的价值. 中华腔镜外科杂志(电子版), 2018, 11(2): 94-97.
28.	周之伟, 王亮, 杨剑逸, 等. 吻合口加固缝合对食管癌根治术后吻合口瘘发生的预防效果. 中华临床医师杂志(电子版), 2021, 15(6): 407-411.
29.	李泳, 程龙庆. 留置肛管对预防直肠癌低位保肛术后吻合口漏的疗效观察. 黑龙江中医药, 2019, 48(3): 53-54.
30.	李伟, 国瑀辰, 所剑. 腹腔镜下保留左结肠动脉的直肠癌D3根治术的争议与体会. 中国普外基础与临床杂志, 2019, 26(8): 912-916.
31.	邢宏彬, 张国强, 李高峰. 腹腔镜超低位直肠癌保肛术中经肛加固缝合吻合口的安全性可行性研究. 中国肛肠病杂志, 2023, 43(5): 16-18.
32.	班搏. 留置肛管在腹腔镜中低位直肠癌保肛术中的应用. 吉林大学, 2022.
33.	闫亚敏, 陆晶晶, 虞正红, 等. 结直肠癌术后留置肛管管理方案的构建与应用研究. 护士进修杂志, 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. 徐晓佳, 王昕, 黄平. 低位直肠癌术后吻合口相关并发症的治疗及改良Bacon术再保肛的要点. 中国普通外科杂志, 2024, 33(4): 553-560.
4. 王朝樣, 林浩, 张海宝, 等. 肠道菌群对结直肠癌术后吻合口漏影响的研究进展. 中国普外基础与临床杂志, 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, 姜昌镐. 结直肠癌术后吻合口漏的相关因素及预防研究进展. 中国普外基础与临床杂志, 2020, 27(11): 1450-1456.
7. 余向南, 付达安, 戴拯, 等. 直肠癌前切除术吻合口漏预防及治疗. 中华普外科手术学杂志(电子版), 2021, 15(5): 587-590.
8. 吴云桦, 陈华, 刘栋, 等. 腹腔镜下中低位直肠癌根治术中吻合口加固缝合预防术后吻合口瘘的效果及对术后恢复的影响. 现代肿瘤医学, 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, 尹瑶, 张超, 等. 3D腹腔镜下经自然腔道取标本直肠癌根治术中保留左结肠动脉的效果观察. 中华实用诊断与治疗杂志, 2023, 37(6): 583-586.
11. 姜慧员, 刘海义, 江波, 等. 保留左结肠动脉在腹腔镜直肠癌前切除术中的临床应用和疗效观察. 中华结直肠疾病电子杂志, 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, 林国乐, 等. 直肠癌新辅助放化疗后根治术行保护性横结肠造口与回肠造口对吻合口漏预防的相关研究. 中华胃肠外科杂志, 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. 金从稳, 王勇, 傅赞. 吻合口加固缝合预防腹腔镜中低位直肠癌前切除术后吻合口漏的临床研究. 徐州医科大学学报, 2022, 42(2): 110-114.
16. 骆洋, 俞旻皓, 陈建军, 等. 倒刺缝线在腹腔镜直肠癌根治术中加固吻合口的应用价值. 中华消化外科杂志, 2020, 19(11): 1205-1210.
17. 蒋天宇, 刘海山, 马君俊, 等. 腹腔镜直肠双吻合术吻合口不同加固方式对吻合口漏的影响. 上海交通大学学报(医学版), 2020, 40(7): 951-956,950.
18. 孙生安, 李朝辉, 张彦, 等. 保留左结肠动脉联合留置肛管在预防低位直肠癌术后吻合口漏中的效果评价. 临床研究, 2021, 29(8): 34-35.
19. 罗迦耀, 方祀福, 赖建勤, 等. 盆底腹膜重建联合肛管引流在预防腹腔镜直肠癌前切除术后吻合口漏的应用. 岭南现代临床外科, 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. 杨亚鹏, 张雪民, 张新伟, 等. 直肠癌低位前切除术后发生吻合口漏的影响因素分析. 中国肛肠病杂志, 2022, 42(6): 1-3.
22. 汪雪, 王梦桥, 刘建, 等. 直肠癌腹腔镜手术中关闭盆底腹膜对术后早期机械性肠梗阻发生的影响及其相关危险因素分析. 实用癌症杂志, 2018, 33(9): 1452-1454.
23. 刘云庚, 张磊, 黄箕然, 等. 腹腔镜下直肠前切除术中保留左结肠动脉对促进患者术后的康复作用. 南方医科大学学报, 2017, 37(9): 1261-1264.
24. 张金强, 李文斌. 腹腔镜直肠癌根治术中保留左结肠动脉对直肠癌患者胃肠功能、免疫系统及远期预后的影响. 贵州医药, 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. 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.
27. 付正伟, 王丽霞, 张振宇, 等. 盆底腹膜重建在3D腹腔镜辅助直肠前切除术中的价值. 中华腔镜外科杂志(电子版), 2018, 11(2): 94-97.
28. 周之伟, 王亮, 杨剑逸, 等. 吻合口加固缝合对食管癌根治术后吻合口瘘发生的预防效果. 中华临床医师杂志(电子版), 2021, 15(6): 407-411.
29. 李泳, 程龙庆. 留置肛管对预防直肠癌低位保肛术后吻合口漏的疗效观察. 黑龙江中医药, 2019, 48(3): 53-54.
30. 李伟, 国瑀辰, 所剑. 腹腔镜下保留左结肠动脉的直肠癌D3根治术的争议与体会. 中国普外基础与临床杂志, 2019, 26(8): 912-916.
31. 邢宏彬, 张国强, 李高峰. 腹腔镜超低位直肠癌保肛术中经肛加固缝合吻合口的安全性可行性研究. 中国肛肠病杂志, 2023, 43(5): 16-18.
32. 班搏. 留置肛管在腹腔镜中低位直肠癌保肛术中的应用. 吉林大学, 2022.
33. 闫亚敏, 陆晶晶, 虞正红, 等. 结直肠癌术后留置肛管管理方案的构建与应用研究. 护士进修杂志, 2023, 38(20): 1835-1841.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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