Kaido Toshimi
Department of Surgery, Otsu Municipal Hospital, Shiga, Japan.
Hepatogastroenterology. 2008 Mar-Apr;55(82-83):438-41.
BACKGROUND/AIMS: Laparoscopic surgery for colorectal cancer has been widely adopted in clinical practice. In this review, recent randomized controlled trials (RCTs) investigating laparoscopic surgery for colorectal cancer are analyzed and the current evidence is summarized to examine the validity of this approach.
We retrieved studies performed via a MEDLINE search to identify prospective RCTs on laparoscopic surgery for colorectal cancer after January 2000. Eligible RCTs were analyzed using the following items: publication year; geographical area and country; study theme; and sample size.
Forty RCTs were analyzed. Most RCTs were carried out in Europe and Asia. Laparoscopic surgery was shown to be, at least as effective as open surgery both in short-term and long-term outcomes and was demonstrated to be a minimally invasive surgery with less effect on homeostasis. Although bladder dysfunction was not, sexual dysfunction was more frequently found in the laparoscopic group in patients with either bulky or low rectal cancers.
Recent RCTs would validate the application of laparoscopic or laparoscopy-assisted surgery for colorectal cancer not only in patients with early colorectal cancer but also in advanced colorectal cancer.
背景/目的：腹腔镜结直肠癌手术已在临床实践中广泛应用。在本综述中，分析了近期研究腹腔镜结直肠癌手术的随机对照试验（RCT），并总结当前证据以检验该方法的有效性。
我们通过MEDLINE检索进行研究，以识别2000年1月以后关于腹腔镜结直肠癌手术的前瞻性RCT。使用以下项目对符合条件的RCT进行分析：发表年份；地理区域和国家；研究主题；以及样本量。
分析了40项RCT。大多数RCT在欧洲和亚洲进行。腹腔镜手术在短期和长期结果方面至少与开放手术一样有效，并且被证明是一种对体内稳态影响较小的微创手术。虽然膀胱功能障碍未出现，但在患有巨大或低位直肠癌的患者中，腹腔镜组性功能障碍的发生率更高。
近期的RCT证实，腹腔镜或腹腔镜辅助手术不仅适用于早期结直肠癌患者，也适用于晚期结直肠癌患者。
