Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, SAR, China.
Colorectal Dis. 2011 Jun;13(6):627-31. doi: 10.1111/j.1463-1318.2010.02235.x. Epub 2010 Feb 15.
Total mesorectal excision (TME) is currently the gold standard for resection of mid or low rectal cancer and is associated with a low local recurrence rate. However, few studies have reported the long-term oncological outcome following use of a laparoscopic approach. The aim of this study was to evaluate the long-term oncological outcome after laparoscopic sphincter-preserving TME with a median follow up of about 4 years.
Patients with mid or low rectal cancer who underwent laparoscopic sphincter-preserving TME with curative intent between March 1999 and March 2009 were prospectively recruited for analysis.
During the 10-year study period, 177 patients underwent laparoscopic sphincter-preserving TME with curative intent for rectal cancer. Conversion was required in two (1%) patients. There was no operative mortality. At a median follow-up period of 49 months, local recurrence had occurred in nine (5.1%) patients. The overall metastatic recurrence rate after curative resection was 22%. The overall 5-year survival and 5-year disease-free survival in the present study were 74% and 71%, respectively.
The results of this study show that laparoscopic sphincter-preserving TME is safe with long-term oncological outcomes comparable to those of open surgery.
全直肠系膜切除术（TME）目前是中低位直肠癌切除的金标准，具有较低的局部复发率。然而，很少有研究报道腹腔镜手术的长期肿瘤学结果。本研究旨在评估中位随访约 4 年后腹腔镜保肛 TME 的长期肿瘤学结果。
1999 年 3 月至 2009 年 3 月期间，前瞻性招募了 177 例接受腹腔镜保肛 TME 治疗的中低位直肠癌患者进行分析。
在 10 年的研究期间，177 例患者接受了腹腔镜保肛 TME 治疗直肠癌，其中 2 例（1%）需要中转开腹。无手术死亡。中位随访 49 个月时，9 例（5.1%）患者发生局部复发。根治性切除术后总转移复发率为 22%。本研究中，5 年总生存率和无病生存率分别为 74%和 71%。
本研究结果表明，腹腔镜保肛 TME 安全，长期肿瘤学结果与开放手术相当。
