Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis
BackgroundThe lateral intersecting margin (dog-ear) was a weak spot of the double stapled technique (DST), We designed “dog-ear” invagination anastomosis (DAIA), which could eliminate the “dog-ear” in laparoscopic anterior resection.Patients and methodsA total of 202 patients underwent elective cura...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1038873/full |
| _version_ | 1797959869744021504 |
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| author | L. Zhang Z. Xie L. Gong X. Lv |
| author_facet | L. Zhang Z. Xie L. Gong X. Lv |
| author_sort | L. Zhang |
| collection | DOAJ |
| description | BackgroundThe lateral intersecting margin (dog-ear) was a weak spot of the double stapled technique (DST), We designed “dog-ear” invagination anastomosis (DAIA), which could eliminate the “dog-ear” in laparoscopic anterior resection.Patients and methodsA total of 202 patients underwent elective curative LLAR + DST (n = 143) or LLAR + DAIA (n = 59) were enrolled in the study. Propensity score matching (PSM) was used to minimize the adverse effects. The clinical data between LLAR + DST and LLAR + DAIA was compared, and the effect of factors on overall survival (OS) and disease-free survival (DFS) was analyzed.ResultsAfter PSM, 53 pairs of the LLRA + DST and LLRA + DAIA patients were enrolled in the study. The LLRA + DAIA group has a higher level (3.50 ± 1.03 vs. 2.87 ± 1.10, P = 0.01) of the anastomosis than that of the LLRA + DST group. Patients in LLAR + DAIA group have a lower incidence of protecting loop ileostomy compared to LLAR + DST group (20.75% vs. 5.66%, P < 0.05). The LLRA + DAIA patients presented better rates of LARS compare to LLRA + DST patients at 6 months (major LARS 37.74% (n = 20) vs. 67.93% (n = 36); P = 0.007) and 12 months (major LARS 13.21% (n = 7) vs. 20.37% (n = 11); P = 0.03) after surgery. The OS and DFS rates were similar (P > 0.05).ConclusionLaparoscopic low anterior resection with “dog-ear” invagination anastomosis technique are well-established procedures for patients with low rectal cancer. “Dog-ear” invagination anastomosis technique may reduce the incidence of protecting loop ileostomy and significantly affect LARS score, and demonstrate a positive impact on the quality of life after surgery. |
| first_indexed | 2024-04-11T00:38:49Z |
| format | Article |
| id | doaj.art-1197be1af224458a852c2c6f4461e530 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T00:38:49Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-1197be1af224458a852c2c6f4461e5302023-01-06T12:49:59ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.10388731038873Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysisL. ZhangZ. XieL. GongX. LvBackgroundThe lateral intersecting margin (dog-ear) was a weak spot of the double stapled technique (DST), We designed “dog-ear” invagination anastomosis (DAIA), which could eliminate the “dog-ear” in laparoscopic anterior resection.Patients and methodsA total of 202 patients underwent elective curative LLAR + DST (n = 143) or LLAR + DAIA (n = 59) were enrolled in the study. Propensity score matching (PSM) was used to minimize the adverse effects. The clinical data between LLAR + DST and LLAR + DAIA was compared, and the effect of factors on overall survival (OS) and disease-free survival (DFS) was analyzed.ResultsAfter PSM, 53 pairs of the LLRA + DST and LLRA + DAIA patients were enrolled in the study. The LLRA + DAIA group has a higher level (3.50 ± 1.03 vs. 2.87 ± 1.10, P = 0.01) of the anastomosis than that of the LLRA + DST group. Patients in LLAR + DAIA group have a lower incidence of protecting loop ileostomy compared to LLAR + DST group (20.75% vs. 5.66%, P < 0.05). The LLRA + DAIA patients presented better rates of LARS compare to LLRA + DST patients at 6 months (major LARS 37.74% (n = 20) vs. 67.93% (n = 36); P = 0.007) and 12 months (major LARS 13.21% (n = 7) vs. 20.37% (n = 11); P = 0.03) after surgery. The OS and DFS rates were similar (P > 0.05).ConclusionLaparoscopic low anterior resection with “dog-ear” invagination anastomosis technique are well-established procedures for patients with low rectal cancer. “Dog-ear” invagination anastomosis technique may reduce the incidence of protecting loop ileostomy and significantly affect LARS score, and demonstrate a positive impact on the quality of life after surgery.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1038873/fulllaparoscopic low anterior resectionpropensity score matchingdouble stapled technique"dog-ear" invagination anastomosisrectal cancer (RC) |
| spellingShingle | L. Zhang Z. Xie L. Gong X. Lv Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis Frontiers in Surgery laparoscopic low anterior resection propensity score matching double stapled technique "dog-ear" invagination anastomosis rectal cancer (RC) |
| title | Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis |
| title_full | Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis |
| title_fullStr | Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis |
| title_full_unstemmed | Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis |
| title_short | Short- and long-term outcomes of laparoscopic low anterior resection with “dog ear” invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis |
| title_sort | short and long term outcomes of laparoscopic low anterior resection with dog ear invagination anastomosis for mid and distal rectal cancer a propensity score matched analysis |
| topic | laparoscopic low anterior resection propensity score matching double stapled technique "dog-ear" invagination anastomosis rectal cancer (RC) |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1038873/full |
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