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腹腔镜与开腹结直肠切除术治疗同期肝转移瘤 R0 切除患者的比较。

Comparison of laparoscopic and open colorectal resections for patients undergoing simultaneous R0 resection for liver metastases.

机构信息

Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 160 Ilsimri, Hwasun-eup, Hwasun-gun, Jeonnam, 519-809, Korea.

出版信息

Surg Endosc. 2011 Jan;25(1):193-8. doi: 10.1007/s00464-010-1158-z. Epub 2010 Jun 12.

Abstract

BACKGROUND

The role of laparoscopic colorectal resection for patients undergoing a simultaneous operation for liver metastases had not been established. This study compared the outcomes between laparoscopic and open colorectal resections for patients undergoing simultaneous surgery for liver metastases.

METHODS

This study reviewed 40 consecutive patients undergoing simultaneous R0 resection of synchronous liver metastases between January 2003 and August 2008. In the study, 20 patients who underwent laparoscopic colorectal resection were matched with 20 patients who had an open approach. All available clinicopathologic variables possibly associated with outcome were compared.

RESULTS

The laparoscopic and open groups had similar demographics. No patient undergoing the laparoscopic procedure experienced conversion to the open technique. No postoperative mortality occurred in either group. The estimated blood loss was significantly lower in the laparoscopic group than in the open group. Although the operating time in the laparoscopic group was significantly longer (358 vs. 278 min; p = 0.004), the patients in this group had bowel function return 1 day sooner on the average than those in the open group. No significant differences in postoperative complications were observed between the groups. The overall survival was 58.7% at 3 years and 49.2% at 5 years. The 3-year overall survival rate in the laparoscopic group was not significantly different from that in the open group (52.8 vs. 61.0%; p = 0.713).

CONCLUSIONS

Laparoscopic colorectal resection with simultaneous resection of liver metastases has an outcome similar to that for an open approach but some short-term advantages.

摘要

背景

腹腔镜结直肠切除术在同时行肝转移灶切除术患者中的作用尚未确定。本研究比较了同期行肝转移灶切除术的患者中腹腔镜与开腹结直肠切除术的疗效。

方法

本研究回顾性分析了 2003 年 1 月至 2008 年 8 月间连续 40 例行同步 R0 肝转移灶切除术的患者。研究中,20 例行腹腔镜结直肠切除术的患者与 20 例行开腹手术的患者相匹配。比较所有可能与预后相关的临床病理变量。

结果

腹腔镜组和开腹组患者的一般情况相似。无腹腔镜手术患者中转开腹。两组均无术后死亡。腹腔镜组的估计失血量明显低于开腹组。尽管腹腔镜组的手术时间明显较长(358 分钟比 278 分钟;p = 0.004),但该组患者术后平均肠功能恢复时间比开腹组提前 1 天。两组术后并发症无显著差异。总体 3 年生存率为 58.7%,5 年生存率为 49.2%。腹腔镜组 3 年总生存率与开腹组无显著差异(52.8%比 61.0%;p = 0.713)。

结论

腹腔镜结直肠切除术联合肝转移灶切除术的疗效与开腹手术相似,但具有一些短期优势。

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