Short‐term outcomes of pelvic floor peritoneum closure in endoscopic low anterior resection of rectal cancer: A propensity score matching analysis

医学 倾向得分匹配 降钙素原 外科 盆底 结直肠癌 子群分析 直肠 盆腔 腹膜 泌尿科 内科学 癌症 败血症 置信区间
作者
Li Chuan,Linfeng Gao,Hongchang Liu,Xiaosong Wang,Luo Huaxing,Chao Zhang,Peiwu Yu,Bo Tang
出处
期刊:Journal of Surgical Oncology [Wiley]
卷期号:123 (1): 271-277 被引量:3
标识
DOI:10.1002/jso.26238
摘要

Abstract Background The efficacy of pelvic floor peritoneum closure (PC) during endoscopic low anterior resection (E‐LAR) of rectal cancer remains unclear. This study aimed to clarify whether pelvic floor PC affected short‐term outcomes. Methods The study group comprised patients with the pathologically confirmed diagnosis of rectal cancer who underwent E‐LAR with pelvic floor PC or with no PC (NPC) between January 2013 and December 2018 in Southwest Hospital. After propensity score matching (PSM), 584 patients (292 who underwent PC and 292 who underwent NPC) were evaluated. Postoperative indicators, including the rates of complications, anastomotic leakage (AL), reoperation, and inflammation, were observed in the two groups. Results No significant difference was observed in the rates of postoperative complications between the PC and NPC groups. The rates of AL were similar (11.3% vs. 9.2%, p = .414). However, the reoperation rate of patients in the PC group was significantly lower than that of patients in the NPC group after AL (36.4% vs. 11.1%, p = .025). The hospital costs were higher in the NPC leakage subgroup ( p = .001). Additionally, the serum C‐reactive protein levels were lower in the PC group on postoperative days (PODs) 1, 3, and 5, whereas procalcitonin levels on POD 1 and 3 were lower in the PC group but did not differ significantly on POD 5. Conclusion Pelvic peritonization did not affect the rate of complications, especially AL; however, it effectively reduced the reoperation and inflammation rates and reduced hospitalization costs. Other short‐term outcomes were similar, which warrant the increased use of pelvic peritonization in endoscopic surgery.
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