Department of Colorectal Surgery, University Hospital, Grenoble cedex, France.
J Gastrointest Surg. 2010 Aug;14(8):1244-7. doi: 10.1007/s11605-010-1228-5. Epub 2010 May 26.
The aim of this study is to compare pathological findings in rectal cancer specimens obtained by laparoscopy or laparotomy.
Bowel length, distal and circumferential margins, and number of total and positive nodes harvested were prospectively recorded in specimens obtained from 100 consecutive patients who had a laparoscopic total mesorectal excision for cancer. These data were compared with those extracted from a well-matched group of 100 patients who had an open procedure.
The mean length of the specimens was 31.04 cm in the case group and 29.45 cm in the control group (not significant (NS)). All distal margins in both groups were negative. The circumferential margin was positive in four cases in the case group and nine cases in the control group (NS). The mean number of lymph nodes harvested was 13.76 nodes/patient in the case group and 12.74 nodes/patient in the control group (NS). The mean number of involved lymph nodes was 1.18 node/case in the case group and 1.96 node/case in group 2 (NS).
There is no difference between laparoscopic or open approaches concerning specimen's length, distal margin, circumferential margin, and total and positive lymph nodes. Laparoscopic rectal resection is not only technically feasible but it seems also oncologically safe.
本研究旨在比较腹腔镜和剖腹手术获取的直肠癌标本的病理发现。
前瞻性记录了 100 例连续接受腹腔镜全直肠系膜切除术治疗癌症的患者标本中的肠长度、远端和环周切缘以及总淋巴结和阳性淋巴结的数量，并与 100 例接受开放性手术的患者的匹配组进行了比较。
病例组标本的平均长度为 31.04cm，对照组为 29.45cm（无显著性差异（NS））。两组的所有远端切缘均为阴性。病例组有 4 例环周切缘阳性，对照组有 9 例（NS）。病例组平均每例患者采集的淋巴结数为 13.76 个，对照组为 12.74 个（NS）。病例组平均受累淋巴结数为 1.18 个/例，对照组为 1.96 个/例（NS）。
腹腔镜或剖腹手术在标本长度、远端切缘、环周切缘以及总淋巴结和阳性淋巴结方面没有差异。腹腔镜直肠切除术不仅在技术上可行，而且似乎在肿瘤学上也是安全的。
