Patient-Reported Outcomes and Surgical Results of Hand-Sewn Versus Stapled Anastomosis for Lower Rectal Cancer Located 4-5 cm From the Anal Verge: A Subanalysis of the Ultimate Study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Numata Masakatsu, Watanabe Jun, Tsukada Yuichiro, Suwa Yusuke, Fukunaga Yosuke, Hirano Yasumitsu, Sakamoto Kazuhiro, Hamamoto Hiroki, Yoshimitsu Masanori, Horie Hisanaga, Matsuhashi Nobuhisa, Kuriu Yoshiaki, Nagai Shuntaro, Hamada Madoka, Yoshioka Shinichi, Ohnuma Shinobu, Hayama Tamuro, Otsuka Koki, Inoue Yusuke, Ueda Kazuki, Toiyama Yuji, Maruyama Satoshi, Yamaguchi Shigeki, Tanaka Keitaro, Naitoh Takeshi, Watanabe Masahiko, Suzuki Motoko, Misumi Toshihiro, Ito Masaaki, Ultimate Trial Group in Japan Society of Laparoscopic Colorectal Surgery
Аннотация
METHODS: This multicenter, single-arm prospective study included patients with cT1-T2/N0/M0 adenocarcinoma located 4-5 cm from the anal verge, scheduled for upfront laparoscopic surgery. Anorectal function, post-operative complications, urinary and male sexual function, and oncological outcomes were assessed using the validated scores.
RESULTS: A total of 135 patients were analyzed and divided into hand-sewn (n = 65) and stapled (n = 70) groups. The patient characteristics were similar, except for the tumors in the hand-sewn group located 1 mm closer to the anal verge. No significant differences were observed in the post-operative complications. Anorectal function, measured using Wexner scores, worsened at 3 months postoperatively and gradually improved in both groups. At 3, 6, 12, 24, and 36 months, the stapled group consistently showed better Wexner scores than the hand-sewn group. Urinary function, sexual function, and oncological outcomes were similar in both groups.
CONCLUSION: Stapled anastomosis may provide better anorectal function with comparable safety and oncological outcomes to hand-sewn anastomosis. Therefore, stapled anastomosis may be preferred for tumors located 4-5 cm from the anal verge to ensure oncological safety.
TRIAL REGISTRATION: This study was registered in the UMIN Clinical Trials Registry System (UMIN 000011750).