Kojima Masayuki, Konishi Fumio, Okada Masaki, Nagai Hideo
Department of Surgery, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi-machi, Tochigi 329-0434, Japan.
Surg Today. 2004;34(12):1020-4. doi: 10.1007/s00595-004-2866-6.
To compare the long-term outcome of laparoscopic-assisted colectomy (LAC) with that of open colectomy (OC) for carcinoma in patients followed up for a minimum of 4 years.
We reviewed the medical records of 118 patients who underwent LAC between January 1993 and September 1999, and compared the results with those of 163 selected patients who underwent OC during the same period.
Curative surgery was performed in 114 of the LAC patients. Because recurrence did not develop in any of the patients with stage I cancer, we analyzed the patterns of recurrence only in those with stage II or III disease; 58 patients were analyzed in the laparoscopic group and 130 in the open colectomy group. In the LAC group, 7 (12.1%) patients had recurrence after a median follow-up of 58 months and in the OC group, 19 (14.6%) patients had recurrence after a median follow-up of 56.5 months. The 5-year disease-free rate was similar in the LAC (87.8%) and OC (85.5%) groups (P = 0.75 by the log-rank test).
Laparoscopic-assisted colectomy is effective and safe for the treatment of colorectal carcinomas under the criteria used in this study. However, further validation of these results is recommended.
比较腹腔镜辅助结肠切除术（LAC）与开腹结肠切除术（OC）治疗结肠癌患者的长期疗效，随访时间至少为4年。
我们回顾了1993年1月至1999年9月期间接受LAC的118例患者的病历，并将结果与同期接受OC的163例选定患者的结果进行比较。
114例LAC患者接受了根治性手术。由于I期癌症患者均未出现复发，我们仅分析了II期或III期疾病患者的复发模式；腹腔镜组分析了58例患者，开腹结肠切除术组分析了130例患者。在LAC组中，中位随访58个月后，7例（12.1%）患者出现复发，在OC组中，中位随访56.5个月后，19例（14.6%）患者出现复发。LAC组（87.8%）和OC组（85.5%）的5年无病生存率相似（对数秩检验P = 0.75）。
在本研究使用的标准下，腹腔镜辅助结肠切除术治疗结直肠癌有效且安全。然而，建议对这些结果进行进一步验证。
