Kim H J, Lee I K, Lee Y S, Kang W K, Park J K, Oh S T, Kim J G, Kim Y H
Department of Surgery, College of Medicine, Incheon St. Mary Hospital, The Catholic University of Korea, #665, Bupyung-6-dong, Bupyunggu, Incheon, 403-720, Korea.
Surg Endosc. 2009 Aug;23(8):1812-7. doi: 10.1007/s00464-009-0348-z. Epub 2009 Mar 5.
The long-term oncologic stability of laparoscopic surgery for colon cancer was established, and laparoscopic surgery was accepted as an alternative to conventional open surgery for colon cancer. However, transverse colon cancer was excluded from the majority of the previous prospective studies. As a result, debate on laparoscopic surgery for transverse colon cancer continues. This study aimed to compare the clinicopathologic outcome of laparoscopic surgery with that of conventional open surgery for transverse colon cancer.
From August 2004 to December 2007, 106 cases of transverse colon cancer were managed by resection at our institution, and 89 of these cases were included in this study. Age, sex, body mass index (BMI), operation time, blood loss, time to first flatus, time to start of diet, hospital stay, complications, tumor size, distal resection margin, proximal resection margin, and number of nodes harvested were compared between the two groups.
No significant differences were found between the laparoscopic and conventional groups in terms of age, sex, BMI, operation time, or hospital stay. The mean blood loss during the operations was significantly less in the laparoscopic group (113.8 +/- 128.9 ml) than in the conventional group (278.8 +/- 268.7 ml; p < 0.05). Moreover, the time to the first flatus was shorter (2.8 +/- 0.9 days vs. 4.4 +/- 2.0 days; p < 0.00) and the diet was started earlier (3.9 +/- 1.7 days vs. 5.4 +/- 1.9 days; p < 0.00) in the laparoscopic group. No intergroup differences in tumor size, proximal resection margin, or number of lymph nodes were observed. The mean distal resection margin was longer in the laparoscopic group (12.5 +/- 4.1 cm vs. 9.2 +/- 6.2 cm; p < 0.05).
Laparoscopic and conventional open surgeries were found to have similar clinical outcomes in transverse colon cancer, and the oncologic quality of laparoscopic surgery was found to be acceptable compared with conventional open surgery.
腹腔镜结肠癌手术的长期肿瘤学稳定性已得到确立,腹腔镜手术被视为结肠癌传统开放手术的替代方案。然而,大多数先前的前瞻性研究将横结肠癌排除在外。因此,关于腹腔镜横结肠癌手术的争论仍在继续。本研究旨在比较腹腔镜手术与传统开放手术治疗横结肠癌的临床病理结果。
2004年8月至2007年12月,我院对106例横结肠癌患者进行了切除治疗,其中89例纳入本研究。比较两组患者的年龄、性别、体重指数(BMI)、手术时间、失血量、首次排气时间、开始进食时间、住院时间、并发症、肿瘤大小、远端切缘、近端切缘以及清扫淋巴结数量。
腹腔镜组与传统组在年龄、性别、BMI、手术时间或住院时间方面未发现显著差异。腹腔镜组手术中的平均失血量(113.8±128.9 ml)明显少于传统组(278.8±268.7 ml;p<0.05)。此外,腹腔镜组的首次排气时间更短(2.8±0.9天对4.4±2.0天;p<0.00),开始进食时间更早(3.9±1.7天对5.4±1.9天;p<0.00)。两组在肿瘤大小、近端切缘或淋巴结数量方面未观察到差异。腹腔镜组的平均远端切缘更长((12.5±4.1 cm对9.2±6.2 cm;p<0.05)。
腹腔镜手术与传统开放手术治疗横结肠癌的临床结果相似,且与传统开放手术相比,腹腔镜手术的肿瘤学质量是可接受的。