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コムラ カズマサ
Kazumasa Komura
小村 和正 所属 川崎医科大学 医学部 臨床医学 泌尿器科学 職種 教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Robotic purse-string suture technique for intracorporeal anastomosis using double-stapling technique in robotic resection of rectal and sigmoid colon cancer: a propensity score-matched analysis. |
| 掲載誌名 | 正式名：BMC surgery 略 称：BMC Surg ISSNコード：14712482/14712482 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 24(1),pp.249 |
| 著者・共著者 | Masayuki Hiraki, Kiminori Yanagisawa, Ryo Ikeshima, Taishi Hata, Kazumasa Komura, Asami Arita, Shinsuke Katsuyama, Go Shinke, Mitsuru Kinoshita, Yoshiaki Ohmura, Keijiro Sugimura, Toru Masuzawa, Yutaka Takeda, Kohei Murata |
| 発行年月 | 2024/09 |
| 概要 | BACKGROUND:Robotic three-dimensional magnified visual effects and field of view stabilization have enabled precise surgical operations. Intracorporeal anastomosis in right-sided colorectal cancer surgery is expected to shorten operation times, avoid paralytic ileus, and shorten wound lengths; however, there are few reports of intracorporeal anvil fixation for intestinal anastomosis in left-sided colorectal cancer surgery. Herein, we introduce a simple, novel procedure for using robotic purse-string suture (RPSS) in intracorporeal anastomosis with the double-stapling technique in rectal and sigmoid cancer surgery and report short-term outcomes.METHODS:From September 2022 to April 2024, 105 consecutive patients underwent robotic surgery with double-stapling technique anastomosis for rectal or sigmoid colon cancer at our institution. Their data were retrospectively analyzed. Intracorporeal anastomosis with the double-stapling technique using RPSS was performed in 26 patients (the RPSS group), while the double-stapling technique anastomosis with extracorporeal anvil fixation was performed in 79 patients (the EC group). A 1:1 propensity score-matched analysis was performed (matching criteria: sex, age, body mass index (BMI), tumor location and tumor size) using a caliper 0.3. In the RPSS group, after tumor-specific or total mesorectal excision, specimens were extracted from the umbilical wound with simultaneous anvil placement in the body cavity. The oral colonic stump was robotically excised and robotically circumferentially stitched with 3-0 Prolene in all layers. After anvil insertion into the stump, the bowel wall of the colon was completely sewn onto the central rod of the anvil. Reconstructions were anastomosed using the double-stapling technique.RESULTS:The matched cohort contained 23 patients in each group. The RPSS group had significantly less bleeding than the EC group (p = 0.038). Super-low anterior resection (SLAR) in the RPSS group had shorter total operativ |
| DOI | 10.1186/s12893-024-02551-8 |
| PMID | 39237904 |