在经过门治疗后的术后尿与腹腔镜整体隔膜切除直肠癌:来自经验丰富的中心的随机试验报告

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Fujin Ye^1,2, Lei Ruan^1,2, Zhanzhen Liu^1,2,3,4

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|August 16, 2024

概括

与腹腔镜方法相比,通过门进行全腹膜切除 (taTME) 并不会增加术后尿的风险. 尿的主要危险因素包括早期导管切除和较高的液体输液率.

科学领域:

结肠直肠手术结肠直肠手术
手术瘤学手术瘤学
泌尿器科泌尿器科泌尿器科泌尿器科

背景情况:

透过门的全腹膜切除术 (taTME) 是腹腔镜TME用于直肠癌的替代方案.
有限的数据存在于taTME对术后尿留 (PUR) 的影响.

研究的目的:

为了确定TATME后PUR的发病率.
在接受taTME的患者中识别与PUR相关的风险因素.

主要方法:

一项随机对照试验 (NCT06147492) 涉及524名患有I-III期直肠癌的患者.
患者被随机分配 (1: 1) 接受眼TME或腹腔镜TME (laTME).
主要结局是手术后尿的发生率.

主要成果:

整体PUR发生率为7.0% (37/524名患者).
在taTME (6.8%) 和laTME (7.2%) 组 (P=0.98) 之间没有观察到PUR的显著差异.
在taTME中PUR的风险因素包括早期导管切除 (P=0.006),高输液率 (P=0.006) 和年龄>65岁 (P=0.0321).

结论:

taTME不会增加术后尿的风险.
建议包括延迟导管切除和在taTME程序中谨慎管理液体.

关键词:

手术后的尿路保留症这是直肠癌.通过门切除全腹膜切除.

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