Tong Daniel K H, Law Wai Lun
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
JSLS. 2007 Jan-Mar;11(1):76-80.
This study aimed to compare the outcomes of laparoscopic resection (LR) with open resection (OR) for right-sided colon cancer.
During the study period from June 2000 to December 2004, 182 patients (84 men) underwent elective resection for cancer of the right colon. Laparoscopic resection was performed in 77 patients, while 105 patients had open operations. Patients who underwent operations on an emergency basis were excluded. Data on the patients' demographics, operative details, and postoperative complications were collected prospectively. The outcomes of patients with laparoscopic resection were compared with those of patients with open surgery.
There was no difference in the age, sex, presence of premorbid medical conditions, and blood loss between the 2 groups. The mean operative time for open resection was 115.4 minutes and that for laparoscopic resection was 165.1 minutes (P<0.001). Among the 77 patients who underwent laparoscopic resection, 7 (9%) required conversion to an open operation. There was no difference in postoperative surgically related complications including wound infection, leakage, intestinal obstruction, postoperative ileus. Nonsurgical-related complications were also similar. The median time to resumption of a normal diet was 3 days and 4 days in the laparoscopic and open groups, respectively. The median hospital stay in patients with laparoscopic resection was significantly shorter than in patients with open surgery (6.0 days vs 7.0 days, P<0.001). The 2-year overall survival rates were 74% in both groups (P=0.904). In the converted to open (LCOR) group, the hospital stay was significantly longer (LR vs OR vs LCOR, 5.5 days vs 7.0 days vs 9.0 days respectively, P<0.001).
Laparoscopic right hemicolectomy is a safe option for cancers of the right colon. It is associated with a shorter hospital stay and earlier resumption of a normal diet. Mortality and morbidity are similar to that with the open approach. There is no compromise in the survival of patients.
本研究旨在比较腹腔镜切除术（LR）与开放切除术（OR）治疗右侧结肠癌的疗效。
在2000年6月至2004年12月的研究期间，182例患者（84例男性）接受了择期右侧结肠癌切除术。77例患者接受了腹腔镜切除术，105例患者接受了开放手术。排除急诊手术患者。前瞻性收集患者的人口统计学数据、手术细节和术后并发症。比较腹腔镜切除术患者与开放手术患者的疗效。
两组患者的年龄、性别、术前合并症情况和失血量无差异。开放切除术的平均手术时间为115.4分钟，腹腔镜切除术的平均手术时间为165.1分钟（P<0.001）。在77例接受腹腔镜切除术的患者中，7例（9%）需要转为开放手术。术后手术相关并发症包括伤口感染、渗漏、肠梗阻、术后肠梗阻无差异。非手术相关并发症也相似。腹腔镜组和开放组恢复正常饮食的中位时间分别为3天和4天。腹腔镜切除术患者的中位住院时间明显短于开放手术患者（6.0天对7.0天，P<0.001）。两组的2年总生存率均为74%（P=0.904）。在转为开放手术（LCOR）组中，住院时间明显更长（LR组、OR组和LCOR组分别为5.5天、7.0天和9.0天，P<0.001）。
腹腔镜右半结肠切除术是治疗右侧结肠癌的安全选择。它与较短的住院时间和较早恢复正常饮食有关。死亡率和发病率与开放手术相似。患者的生存率没有受到影响。
