Department of Gastroenterological Surgery, Cancer Institute Hospital, Gastroenterological Center, 3-10-6 Ariake, Koto-ku, Tokyo 135-8550, Japan.
J Gastrointest Surg. 2010 May;14(5):818-23. doi: 10.1007/s11605-010-1182-2. Epub 2010 Mar 12.
The role of laparoscopic surgery for transverse colon cancer (TCC) remains controversial. This study aimed to evaluate the safety of laparoscopic resection of TCC.
Fifty-three patients undergoing laparoscopic resection of TCC (group A) were compared with 39 patients undergoing open resection of TCC (group B) and 200 patients undergoing laparoscopic resection of ascending or descending colon cancer (group C).
Mean operating time was longer (224 vs. 157 min), and mean estimated blood loss was lower (40 vs. 79 ml) in group A than in group B, but these were similar in groups A and C. The rates of conversion to open surgery were similar in groups A and C (1.9% vs. 1.0%). Tumor stage was more advanced in group B than in group A. All patients in groups A and B underwent pathologic R0 resection. The rates of postoperative complications did not differ significantly between groups (9.4% vs. 7.7% vs. 5.0%). Time to flatus (1.7 vs. 2.5 days), time to liquid diet (2.4 vs. 5.3 days), and hospital stay (12 vs. 15 days) were significantly shorter in group A than in group B, but similar in groups A and C.
Laparoscopic resection for TCC can be performed safely with similar short-term postoperative outcomes seen for colon cancer at other sites. Laparoscopic resection may be associated with faster gastrointestinal recovery and shorter length of hospital stay, compared with open surgery.
腹腔镜手术治疗横结肠癌(TCC)的作用仍存在争议。本研究旨在评估腹腔镜 TCC 切除术的安全性。
将 53 例行腹腔镜 TCC 切除术的患者(A 组)与 39 例行开腹 TCC 切除术的患者(B 组)和 200 例行腹腔镜升结肠或降结肠癌切除术的患者(C 组)进行比较。
A 组的手术时间较长(224 分钟比 157 分钟),估计出血量较少(40 毫升比 79 毫升),但与 C 组相似。A 组和 C 组中转开腹率相似(1.9%比 1.0%)。B 组的肿瘤分期较 A 组晚。A 组和 B 组所有患者均行病理 R0 切除。术后并发症发生率在各组间无显著差异(9.4%比 7.7%比 5.0%)。A 组的肛门排气时间(1.7 天比 2.5 天)、进液饮食时间(2.4 天比 5.3 天)和住院时间(12 天比 15 天)明显短于 B 组,但与 C 组相似。
对于 TCC,腹腔镜切除术可安全进行,与其他部位结肠癌相比,短期术后结果相似。与开腹手术相比,腹腔镜切除术可能与更快的胃肠恢复和更短的住院时间相关。