陆军军医大学学报 (Mar 2024)

Rubber-coated stent as a fecal isolation device to prevent postoperative anastomotic leakage after low rectal cancer: a cross-sectional study for efficacy

  • CHEN Qi,
  • ZHANG Shuntao,
  • GAO Yuchen

DOI
https://doi.org/10.16016/j.2097-0927.202310035
Journal volume & issue
Vol. 46, no. 5
pp. 467 – 476

Abstract

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Objective To investigate the application of rubber-coated stent (RCS) as a fecal isolation device in preventing anastomotic leakage after low rectal cancer surgery. Methods A total of 72 patients who underwent laparoscopic radical resection of rectal cancer (Dixon) at Yongchuan Hospital of Chongqing Medical University from January 2016 to April 2023 were studied, and 35 of them who underwent defunctioning stoma (DS) were assigned into control group, and another 37 ones receiving RCS served as the study group. Their general data, operation time, length of hospital stay, incidence of overall complications, hospitalization cost, anastomotic leakage rate, and other related clinical indicators were collected and compared between the 2 groups. Results There were no statistical differences between the 2 groups in term of general data (age, gender, BMI, NRS-2002 score, ASA score, tumor stage and distance from the tumor to the anal verge) and proportions of underlying diseases (diabetes mellitus, hypertension, other cardiovascular diseases, and chronic obstructive pulmonary disease) (P>0.05). The study group had significantly shorter operation time (238.0 vs 314.1 min, P<0.001) and length of postoperative hospital stay (11 vs 12 d, P=0.040), lower incidence of overall complications (18.9% vs 51.4%, P=0.004), and less hospital cost (48 327 vs 53 092 Yuan, P=0.012) when compared with the control group. The rate of anastomotic leakage was slightly lower in the study group than the control group, though without statistical significance (2.7% vs 8.6%, P=0.350). Conclusion In Dixon surgery, RCS shortens the operation time and length of hospital stay, reduces hospital cost and overall complications, and does not increase the risk of postoperative anastomotic leakage in comparison of conventional surgery. It can be used as a surgical alternative to DS.

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