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结肠癌的小切口剖腹手术入路

Minilaparotomy approach to colon cancer.

作者信息

Takegami Kenji, Kawaguchi Yoneei, Nakayama Hiroshi, Kubota Yoshiro, Nagawa Hirokazu

机构信息

Department of Surgery, Kikkoman General Hospital, Chiba, Japan.

出版信息

Surg Today. 2003;33(6):414-20. doi: 10.1007/s10595-002-2534-8.

Abstract

PURPOSE

Many studies have proved the feasibility and safety of a laparoscopic colectomy in comparison to a conventional laparotomy. However, a laparoscopic colectomy requires a minilaparotomy incision to perform the operative procedure. We have introduced a minilaparotomy technique which can perform all the operative procedures through incisions measuring from 3 to 7 cm in length.

METHODS

A retrospective comparison of the outcome after a potentially curative resection of colon cancers via minilaparotomy (July 2000 to May 2002) and by conventional laparotomy (May 1997 to June 2000) is reported.

RESULTS

The patient cohort consisted of 27 minilaparotomy cases and 24 conventional laparotomy cases. The patients' characteristics were similar in the two groups. The oncological clearance, in terms of the length of resected specimens, was similar in the two groups, whereas the number of lymph nodes removed was significantly higher in the minilaparotomy group. In addition, the mean operation time, blood loss, length of the laparotomy incision, postoperative time to walking, starting oral intake, and postoperative hospitalization were significantly smaller in the minilaparotomy group.

CONCLUSION

Our minilaparotomy approach maintained the same curative resection for colon cancers as a conventional laparotomy, but it was less invasive and allowed for an earlier recovery and hospital discharge than conventional laparotomy. The minilaparotomy approach is thus considered to be an attractive alternative to conventional colon surgery.

摘要

目的

与传统开腹手术相比,许多研究已证实腹腔镜结肠切除术的可行性和安全性。然而,腹腔镜结肠切除术需要一个小切口开腹来进行手术操作。我们引入了一种小切口开腹技术,该技术可通过长度为3至7厘米的切口完成所有手术操作。

方法

报告了对2000年7月至2002年5月通过小切口开腹和1997年5月至2000年6月通过传统开腹进行的结肠癌潜在根治性切除术后结果的回顾性比较。

结果

患者队列包括27例小切口开腹病例和24例传统开腹病例。两组患者的特征相似。就切除标本的长度而言,两组的肿瘤清除情况相似,而小切口开腹组切除的淋巴结数量明显更多。此外,小切口开腹组的平均手术时间、失血量、开腹切口长度、术后步行时间、开始经口进食时间和术后住院时间均明显更短。

结论

我们的小切口开腹方法对结肠癌的根治性切除与传统开腹手术相同,但它的侵入性更小,比传统开腹手术恢复更早且出院更早。因此,小切口开腹方法被认为是传统结肠手术的一种有吸引力的替代方法。

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