A Comparative Study Of The Clinical Safety And Advantages Of Overlap Anastomosis And FEEA In Laparoscopic Radical Colon Cancer Surgery

Objective: To investigate the clinical safety and short-term efficacy of Overlap anastomosis with FEEA in laparoscopic radical colon cancer surgery.Methods: A retrospective cohort study was used to collect clinical data of patients who underwent laparoscopic radical colon cancer surgery and lateral anastomosis between January 2017 and December 2019 in the Department of Gastrointestinal Surgery at affiliated Hospital of Zunyi Medical University.Combining the inclusion and exclusion criteria,129 patients were finally included in the study,including 79 males and 50 females,with an age range of 28-71 years,64 patients undergoing Overlap anastomosis(Overlap anastomosis group)and 65 patients undergoing FEEA(FEEA group).The patients in both groups were counted for(1)General clinical data: age,gender,BMI,preoperative ALB value,tumor site,tumor diameter and TNM stage;(2)Intraoperative and postoperative recovery: operative time,intraoperative bleeding,number of lymph node dissection,abdominal wall incision length,postoperative hospital stay,postoperative time to exhaustion,postoperative time to food and postoperative 24-h pain score;(3)Postoperative perioperative complications: whether incisional infection,abdominal infection,pulmonary infection,incisional hernia,anastomotic leak,anastomotic bleeding,anastomotic stricture and intestinal obstruction,and their incidence;(4)Postoperative follow-up: quality of life at postoperative months 3,6,9 and 12,and the presence of recurrence,metastasis and death within 12 months after surgery.SPSS 21.0 was used for statistical analysis of the data,and P<0.05 was considered a statistically significant difference.Results:(1)Comparison of general clinical data: There were no statistically significant differences in age,gender,BMI,preoperative ALB value,tumor site,tumor diameter and TNM stage in the Overlap anastomosis group compared with the FEEA group(P>0.05).(2)Comparison of intraoperative and postoperative recovery: the operative time in the Overlap anastomosis group was shorter than that in the FEEA group [(185.3±23.6)min versus(199.7±33.8)min,t=2.811,P=0.006];the postoperative bowel function recovery was faster in the Overlap anastomosis group: the postoperative venting time [(3.3±1.1)d versus(3.8±1.2)d,t=2.450,P=0.016],postoperative feeding time [(4.4±1.0)d versus(4.8±1.2)d,t=2.077,P=0.040],and postoperative hospital stay [(8.6±1.8)d versus(9.7±1.9)d,t=3.474,P=0.001] were shorter than those in the FEEA group.There were no statistically significant differences in abdominal wall incision length,intraoperative bleeding,number of lymph nodes cleared and 24-h postoperative pain score in the Overlap anastomosis group compared with the FEEA group(P>0.05).(3)Comparison of postoperative perioperative complications: The incidence of postoperative complications in the Overlap anastomosis group was not statistically significant compared with that in the FEEA group(P>0.05).(4)Comparison of postoperative follow-up: QOL scores of patients in the Overlap anastomosis group at the 3rd,6th,9th and 12 th months after surgery were not statistically significant compared with those in the FEEA group(P>0.05);liver metastases occurred in 2 cases in the Overlap anastomosis group and liver metastases in 2 cases and lung metastases in 1 case in the FEEA group,and the differences were not statistically significant(P>0.05);there was no recurrence and death in both groups during the 12 months of follow-up.Conclusion: Overlap anastomosis,compared to FEEA,can shorten the operative time and speed up the recovery of postoperative bowel function without increasing the rate of postoperative complications in patients,and also does not affect the quality of life and survival of patients in the short term after surgery.Therefore,Overlap anastomosis is a safe,effective and advantageous way to reconstruct the colonic digestive tract and is worthy of clinical promotion.