Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Langenbecks Arch Surg. 2010 Mar;395(3):207-10. doi: 10.1007/s00423-009-0514-8. Epub 2009 Jun 4.
Increasingly, laparoscopy-assisted gastrectomy and laparoscopy-assisted colorectal surgery are being performed. However, simultaneous laparoscopic surgery for synchronous gastric and colorectal cancer is rare and its feasibility unknown.
Early surgical outcomes, including operation time, intraoperative bleeding, postoperative morbidity, mortality, and the duration of the postoperative hospital stay, were investigated in seven consecutive patients who underwent simultaneous laparoscopy-assisted gastrectomy and colorectal surgery at the Cancer Institute Hospital between 2005 and 2008 to clarify the feasibility of simultaneous laparoscopic surgery.
Mean operation time was 392 min and estimated blood loss was 90 mg in patients undergoing simultaneous laparoscopic surgery. Although postoperative morbidity was observed in three patients (surgical site infection, gastric fullness, and enteritis), they recovered well, and the duration of postoperative hospital stay was 19.6 +/- 14.1 days. There was no postoperative mortality. Intraoperative complication which required conversion to open surgery was also not found in any of the patients. A small incision measuring 5-6 cm in length was sufficient for both retrieval of resected specimen and enteric anastomosis in all patients.
The laparoscopic approach is a feasible procedure for synchronous gastric and colorectal cancer, provided that the operation is performed by experienced surgeons.
越来越多的腹腔镜辅助胃切除术和腹腔镜辅助结直肠手术正在进行。然而,同时进行腹腔镜下胃和结直肠癌手术的情况很少见,其可行性尚不清楚。
本研究回顾性分析了 2005 年至 2008 年期间在癌症研究所医院接受同期腹腔镜辅助胃切除术和结直肠手术的 7 例连续患者的早期手术结果,包括手术时间、术中出血量、术后发病率、死亡率和术后住院时间,以明确同期腹腔镜手术的可行性。
同时进行腹腔镜手术的患者的平均手术时间为 392 分钟,估计出血量为 90 毫克。虽然有 3 例患者(切口感染、胃部饱胀和肠炎)发生术后并发症,但均恢复良好,术后住院时间为 19.6 +/- 14.1 天。无术后死亡。也没有患者发生需要转为开腹手术的术中并发症。所有患者均通过 5-6cm 的小切口取出切除标本并进行肠吻合。
对于经验丰富的外科医生来说,腹腔镜方法是一种可行的治疗同时性胃和结直肠癌的方法。