Di Palo S, Vignali A, Tamburini A, Parolini D, Orsenigo E, Staudacher C
Dipartimento di Chirurgia, IRCCS San Raffaele, Università Vita-Salute, Milano.
Suppl Tumori. 2005 May-Jun;4(3):S133-4.
To analyze the results of laparoscopic colectomy for cancer of colon and rectum on early outcome.
Fifty hundred and ninety-nine consecutive unselected patients who underwent laparoscopic colectomy for cancer of the colon or rectum between January 1998 and December 2004 in a single Institution were prospectively evaluated. Tumor classification was by TNM stage. Patients were monitored for postoperative complications for 30 days after surgery. Follow-up was done by direct patient contact.
Mean (SD) age was 65.8 (11.7) years. Mean (SD) ASA score was 2.0 (0.5). The following operations were performed: 248 left colectomies, 131 right colectomies, 26 sigmoid resections, 164 rectal resections, 21 abdominoperineal resections (Miles operation) and 9 total colectomies. Conversion rate was 7.2% (43/599 pts). The overall morbidity rate was 23.3% (143/599 pts). The mortality rate was 0.3% (2/599 pts). Anastomotic leak occurred in 45/599 (7.3%) patients. Re-operation rate was 4.6% (26/599 pts). Mean (SD) length of stay was 9.9 (5.8) days. The mean number (SD) of lymphnodes intraoperatively collected was 16.7 (9.8). Median (range) time of follow-up period was 20.2 months (6-68). One port-site metastasis was found at 18 months after surgery. Overall 5-years survival was 81%. Local recurrence rate in patients who underwent TME of the rectum was 4.4%.
Laparoscopic colectomies is safe and effective in the treatment of colon and rectal cancer.
分析腹腔镜结肠切除术治疗结肠癌和直肠癌的早期疗效。
对1998年1月至2004年12月在单一机构接受腹腔镜结肠切除术治疗结肠癌或直肠癌的599例连续入选患者进行前瞻性评估。肿瘤分类采用TNM分期。术后对患者进行30天的并发症监测。通过直接与患者联系进行随访。
平均（标准差）年龄为65.8（11.7）岁。平均（标准差）ASA评分2.0（0.5）。实施了以下手术：248例左半结肠切除术、131例右半结肠切除术、26例乙状结肠切除术、164例直肠切除术、21例腹会阴联合切除术（Miles手术）和9例全结肠切除术。中转率为7.2%（43/599例患者）。总体发病率为23.3%（143/599例患者）。死亡率为0.3%（2/599例患者）。45/599（7.3%）例患者发生吻合口漏。再次手术率为4.6%（26/599例患者）。平均（标准差）住院时间为9.9（5.8）天。术中平均（标准差）采集的淋巴结数量为16.7（9.8）个。随访期的中位（范围）时间为20.2个月（6 - 68个月）。术后18个月发现1例切口种植转移。总体5年生存率为81%。接受直肠系膜全切除术的患者局部复发率为4.4%。
腹腔镜结肠切除术治疗结肠癌和直肠癌安全有效。
