Uehara Keisuke, Yamamoto Seiichiro, Fujita Shin, Akasu Takayuki, Moriya Yoshihiro
Division of Colorectal Surgery, National Cancer Center Hospital in Tokyo, Japan.
Hepatogastroenterology. 2006 Jul-Aug;53(70):531-5.
BACKGROUND/AIMS: The present study evaluated the short- and middle-term surgical outcomes of laparoscopic surgery (LS) for rectal carcinoma in comparison with a case-control series of open surgery (OS).
Between February 1998 and December 2004, 47 patients with rectal carcinoma underwent LS. These patients were compared with a conventional OS group matched for age, gender, location of tumor, surgical procedure, extent of resection and pathological stage.
The median follow-up period for the LS group and the OS group was 25 and 49 months, respectively. In the LS group, median operative time was significantly longer but median blood loss was lower than those in the OS group. There was one requiring conversion to OS. Postoperative intervals until liquid and solid intakes, and hospital stay were significantly shorter in the LS group. Postoperative complications rates are similar and anastomotic leakage occurred in one patient in each group. In the LS group, the levels of white blood cell count on postoperative day 1 and C-reactive protein on postoperative days 1 and 2 were significantly lower than those in the OS group.
LS for rectal carcinoma provides benefits during the early postoperative period without increase in morbidity or mortality.
背景/目的：本研究对比了腹腔镜手术（LS）与开放手术（OS）病例对照系列治疗直肠癌的短期和中期手术结果。
1998年2月至2004年12月期间，47例直肠癌患者接受了LS。将这些患者与按年龄、性别、肿瘤位置、手术方式、切除范围和病理分期匹配的传统OS组进行比较。
LS组和OS组的中位随访期分别为25个月和49个月。在LS组中，中位手术时间明显更长，但中位失血量低于OS组。有1例需要转为OS。LS组直到液体和固体摄入的术后间隔时间以及住院时间明显更短。术后并发症发生率相似，每组各有1例患者发生吻合口漏。在LS组中，术后第1天的白细胞计数以及术后第1天和第2天的C反应蛋白水平明显低于OS组。
直肠癌的LS在术后早期具有优势，且不增加发病率或死亡率。
