Application of optimized common ostium closure technique in Overlap anastomosis for 3D laparoscopic radical resection of right-sided colon cancer

doi:10.3877/cma.j.issn.1674-0793.2026.04.006

Abstract

Abstract:

Objective

To explore the effect of optimized common ostium closure technique in Overlap anastomosis for 3D laparoscopic radical resection of right-sided colon cancer, and clarify its impact on surgical efficiency, postoperative complications and patient recovery.

Methods

The clinical data of 211 patients who underwent 3D laparoscopic radical resection of right-sided colon cancer (Overlap anastomosis) from July 2019 to December 2024 were retrospectively analyzed. The patients were divided into observation group (100 cases, barbed suture continuous suture + seromuscular reinforcement) and control group (111 cases, linear cutting stapler + seromuscular reinforcement) according to different common ostium closure methods. Intraoperative indicators, postoperative recovery, total costs, quality of life (QoL) score and complications were compared between the two groups.

Results

Intraoperative blood loss, time to first flatus, postoperative hospital stay and total hospitalization costs in the observation group were significantly better than those in the control group (P<0.001). There were no significant differences in operation duration, QoL scores 1-6 months after surgery and complication rates between the two groups.

Conclusion

The optimized technique can reduce blood loss, accelerate recovery, reduce costs, and does not increase the risk of complications, which is worthy of promotion.

Key words: Imaging, three-dimensional, Laparoscopes, Radical resection of right-sided colon cancer, Overlap anastomosis, Common ostium closure, Barbed suture, Postoperative complications

Hao Sun, Zheng Zheng, Shaowei Ye, Siquan Zhong, Hongzhi Luo, Chunzai Feng, Hong Chen, Shihai Zhou. Application of optimized common ostium closure technique in Overlap anastomosis for 3D laparoscopic radical resection of right-sided colon cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2026, 20(04): 252-256.

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References 29

［1］	Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1): 47–53.
［2］	姚宏伟, 李心翔, 崔龙, 等. 中国结直肠癌手术病例登记数据库2019年度报告: 一项全国性登记研究[J]. 中国实用外科杂志, 2020, 40(1): 106–110, 116.
［3］	姜慧员, 赵前, 高晟, 等. 基于膜解剖的腹腔镜右半结肠癌根治术与传统腹腔镜手术疗效的对比研究[J]. 中华普通外科杂志, 2024, 39(8): 577–583.
［4］	中华医学会外科学分会结直肠外科学组, 中国结直肠临床研究协作组. 右半结肠癌手术中国专家共识(2024版)[J]. 中华胃肠外科杂志, 2024, 27(9): 879–890.
［5］	Chaouch MA, Dougaz MW, Mesbehi M, et al. A meta-analysis comparing hand-assisted laparoscopic right hemicolectomy and open right hemicolectomy for right-sided colon cancer[J]. World J Surg Oncol, 2020, 18(1): 91.
［6］	中华人民共和国国家卫生健康委员会. 中国结直肠癌诊疗规范(2023版)[J]. 中华消化外科杂志, 2023, 22(6): 667–698.
［7］	中华医学会外科学分会腹腔镜与内镜外科学组, 中华医学会外科学分会结直肠外科学组, 中国医师协会外科医师分会结直肠外科医师委员会, 等. 腹腔镜结直肠癌根治术操作指南(2018版)[J]. 中华消化外科杂志, 2018, 17(9): 877–885.
［8］	白军伟, 张超, 王志凯, 等. 全腹腔镜下平行重叠吻合法在3D腹腔镜右半结肠癌根治术中的应用价值[J]. 中华消化外科杂志, 2020, 19(1): 93–98.
［9］	韩博, 崔宏帅, 鞠倩, 等. 不同吻合方式在结肠癌腹腔镜右半结肠切除术中的应用效果及预后分析[J/OL]. 中华消化病与影像杂志(电子版), 2025, 15(5): 431–435.
［10］	姚宏伟, 高加勒, 庞凯, 等. 腹腔镜右半结肠癌切除术后消化道重建的研究现状及前景[J]. 中华消化外科杂志, 2021, 20(3): 255–259.
［11］	Allaix ME, Degiuli M, Bonino MA, et al. Intracorporeal or extracorporeal ileocolic anastomosis after laparoscopic right colectomy: A double-blinded randomized controlled trial[J]. Ann Surg, 2019, 270(5): 762–767.
［12］	中华医学会外科学分会. 腹腔镜胃外科手术缝合技术与缝合材料选择中国专家共识(2021版)[J]. 中国实用外科杂志, 2021, 41(5): 495–503.
［13］	江兵, 杨侃侃, 陈锐. 自牵引后离断顺蠕动食管空肠吻合在全腹腔镜全胃切除术中的应用效果[J]. 安徽医学, 2021, 42(3): 245–247.
［14］	Clapp B, Klingsporn W, Lodeiro C, et al. Small bowel obstructions following the use of barbed suture: A review of the literature and analysis of the MAUDE database[J]. Surg Endosc, 2020, 34(3): 1261–1269.
［15］	姚宏伟, Jurriaan Tunmann, 张忠涛, 等. 基于COLOR Ⅳ研究分析腹腔镜右半结肠癌根治术的标准化流程和质量控制要点[J]. 中国实用外科杂志, 2023, 43(10): 1100–1103.
［16］	万崇华, 陈明清, 张灿珍, 等. 欧洲癌症研究与治疗组织生活质量核心量表(QLQ-C30) 中文版的信度与效度评价[J]. 中国肿瘤临床, 2003, 30(5): 353–355.
［17］	王志凯, 张建成, 张超, 等. 腹腔镜右半结肠癌根治术中采用平行重叠吻合法胃肠道重建后经阴道取标本临床观察[J]. 中华实用诊断与治疗杂志, 2022, 36(9): 925–927.
［18］	赵威, 董元航, 梅祖兵. 腹腔镜右半结肠切除术中腔内吻合对比腔外吻合对术后并发症的影响的Meta分析[J]. 结直肠肛门外科, 2022, 28(5): 482–487.
［19］	Bollo J, Turrado V, Rabal A, et al. Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy (IEA trial)[J]. Br J Surg, 2020, 107(4): 364–372.
［20］	王兴琴, 谢铭. Overlap吻合方式在胃肠道重建中的研究进展[J]. 中华普通外科杂志, 2022, 37(8): 630–633.
［21］	李心翔, 翁俊勇. 腹腔镜结直肠手术消化道重建中吻合失败及对策[J]. 中国实用外科杂志, 2022, 42(11): 1219–1224.
［22］	Milone M, Sganga G, Casella G, et al. Impact of suture technique on anastomotic leakage in laparoscopic colorectal surgery: A multicenter observational study[J]. Surg Endosc, 2022, 36(10): 6892–6901.
［23］	包满都拉, 葛磊, 苏昊, 等. 重叠式三角吻合技术在完全腹腔镜左半结肠切除术消化道重建中的安全性与可行性[J]. 中华胃肠外科杂志, 2021, 24(5): 433–439.
［24］	包满都拉, 苏昊, 罗寿, 等. 完全腹腔镜右半结肠切除术中应用重叠式三角吻合技术行消化道重建的安全性和可行性[J]. 中华肿瘤杂志, 2022, 44(5): 436–441.
［25］	Wang X, Wang P, Hong J, et al. Application of overlapped delta-shaped anastomosis technique in totally laparoscopic right hemicolectomy[J]. Zhonghua Wei Chang Wai Ke Za Zhi, 2018, 21(11): 1255–1260.
［26］	廖梓群, 陈维荣, 陈喜贵, 等. 改良三角吻合技术在完全腹腔镜左半结肠切除术中的应用[J]. 中华胃肠外科杂志, 2016, 19(6): 712–713.
［27］	罗锐, 戈应刚, 吴星烨, 等. 全腹腔镜下远端胃癌根治加三角吻合术后远期生存情况观察[J]. 中华胃肠外科杂志, 2016, 19(5): 549–552.
［28］	周志祥, 周海涛. 理念及科技创新推动着结直肠癌微创外科前行[J]. 肿瘤防治研究, 2015, 42(1): 1–3.
［29］	Zeng WG, Zhou ZX. Mini-invasive surgery for colorectal cancer[J]. Chin J Cancer, 2014, 33(6): 277–284.

组别	例数	年龄（岁）^a	性别（男/女，例）	BMI(kg/m²)^a	TNM分期（Ⅰ/Ⅱ/Ⅲ，例）	肿瘤长径（cm）^a	术前白蛋白（g/L）^a	术前血红蛋白（g/L）^a
观察组	100	56.8±9.2	58/42	23.5±2.1	12/45/43	4.2±1.1	37.8±3.5	125.3±13.5
对照组	111	57.5±8.8	65/46	23.8±2.3	15/48/48	4.3±1.2	38.1±3.7	123.8±12.9
t/χ²值		-0.542	0.087	-0.985	0.512	-0.613	-0.596	0.782
P值		0.588	0.768	0.326	0.774	0.540	0.552	0.435

组别	例数	年龄（岁）^a	性别（男/女，例）	BMI(kg/m²)^a	TNM分期（Ⅰ/Ⅱ/Ⅲ，例）	肿瘤长径（cm）^a	术前白蛋白（g/L）^a	术前血红蛋白（g/L）^a
观察组	100	56.8±9.2	58/42	23.5±2.1	12/45/43	4.2±1.1	37.8±3.5	125.3±13.5
对照组	111	57.5±8.8	65/46	23.8±2.3	15/48/48	4.3±1.2	38.1±3.7	123.8±12.9
t/χ²值		-0.542	0.087	-0.985	0.512	-0.613	-0.596	0.782
P值		0.588	0.768	0.326	0.774	0.540	0.552	0.435

组别	例数	手术时间（min）	术中失血量（ml）	术后首次排气时间（d）	术后住院天数（d）	总住院费用（万元）
观察组	100	157.2±15.6	28.5±8.7	2.1±0.5	6.2±1.3	5.8±0.6
对照组	111	152.8±18.3	34.1±9.2	2.6±0.6	7.5±1.5	6.5±0.8
t值		1.823	4.431	-6.842	-6.315	-6.783
P值		0.069	<0.001	<0.001	<0.001	<0.001

组别	例数	手术时间（min）	术中失血量（ml）	术后首次排气时间（d）	术后住院天数（d）	总住院费用（万元）
观察组	100	157.2±15.6	28.5±8.7	2.1±0.5	6.2±1.3	5.8±0.6
对照组	111	152.8±18.3	34.1±9.2	2.6±0.6	7.5±1.5	6.5±0.8
t值		1.823	4.431	-6.842	-6.315	-6.783
P值		0.069	<0.001	<0.001	<0.001	<0.001

组别	例数	术后1个月	术后3个月	术后6个月
观察组	100	48.6±4.2	52.3±3.8	55.1±3.5
对照组	111	47.9±4.5	51.8±4.1	54.7±3.7
t值		1.128	0.935	0.824
P值		0.261	0.351	0.411

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