Technical considerations depending on the level of vascular ligation in laparoscopic rectal resection
| Autor: | D. Tzoneva, Gribnev P, Svilen Maslyankov, Sokolov M, Petrov B, Margarita Atanasova, Angelov K |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Rectum Anastomotic Leak Anastomosis Lower risk Cohort Studies 03 medical and health sciences 0302 clinical medicine medicine Humans Prospective Studies Lymph node Ligation business.industry Rectal Neoplasms Hypogastric Plexus Mesenteric Artery Inferior Surgery Dissection medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Laparoscopy business Abdominal surgery |
| Zdroj: | Surgical endoscopy. 36(3) |
| ISSN: | 1432-2218 |
| Popis: | In addition to ischemia there is also anastomotic ends tension proven to be a risk factor for anastomotic leak. HT vascular ligation is accepted as a rule, in attempt to achieve tension-free anastomosis. LT is a preferred option, based on the more accurate preservation of proximal intestinal segment microperfusion and lower risk of damage to the hypogastric plexus. The aim of this study is evaluation of comparative indicators in high tie (HT) and low tie (LT) laparoscopic rectal resections. A prospective nonrandomized comparative cohort study of patients in our department with cancer of the rectum in clinical stage I–III, operated on in laparoscopic approach over a 6-years period. For the period 2015–2020, a number of 208 laparoscopic surgeries have been done for rectal cancer. Patients were divided into three groups—group A with HT vascular ligation 116 pts. (69%), group B—53 pts. (25%), underwent low ligation—LT and group C—39pts. (19%) low tie plus lymph node dissection of the apical LN group (LT-appic LND). The distribution was made without randomization, based on the operators’ expertise. Anastomotic leaks were 3.8% in group A, 3.0% in group B and 2.9% in group C (p > 0.05) with no significance difference. There is no significant difference in the number of lymph nodes obtained in group A and group B, while in group C the number of the harvested lymph nodes was higher (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink