Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
Singapore Med J. 2010 Aug;51(8):650-4.
Evidence from randomised controlled trials has shown that laparoscopic colon and rectal cancer resection not only confers short-term benefits but also does not differ considerably in terms of its long-term oncological outcomes, as compared with open surgery.
All laparoscopic colon and rectal resections performed between January 2005 and December 2007 were included. Patient records were reviewed from a prospective database and the relevant clinical data was obtained, with a subgroup analysis of cancer procedures performed.
418 patients (247 male), median age 63 years (range 24 to 88), underwent laparoscopic resection of the colon and rectum. The median Body Mass Index (BMI) was 22.5 (range 13.5 to 39.3). The majority of the procedures were performed for malignant disease (81.3 percent) and the most common procedure was anterior resection (79.4 percent). The median duration of surgery was 135 minutes (range 65 to 330), with conversions to open surgery in 44 patients (10.5 percent). Complications occurred in 78 patients (18.7 percent), including anastomotic leaks in five (1.20 percent). The median length of hospital stay was five days (range 3 to 90) and the median follow-up was 19 months (range 1 to 46). In the 340 patients with malignant disease, the median number of lymph nodes harvested was 13 (range 5 to 48), and at the latest review, 230 patients (67.6 percent) were disease-free, with locoregional recurrence in 2.9 percent and systemic recurrence in 10 percent.
To date, this is the largest series of laparoscopic colorectal resections reported locally, and our results show that it is safe, feasible and produces favourable results.
随机对照试验的证据表明，腹腔镜结肠和直肠肿瘤切除术不仅具有短期优势，而且在长期肿瘤学结果方面与开放手术相比也没有明显差异。
纳入 2005 年 1 月至 2007 年 12 月期间进行的所有腹腔镜结肠和直肠切除术。从前瞻性数据库中回顾患者记录并获取相关临床数据，并对癌症手术进行亚组分析。
418 名患者（247 名男性），中位年龄 63 岁（范围 24 至 88 岁），接受腹腔镜结肠和直肠切除术。中位体重指数（BMI）为 22.5（范围 13.5 至 39.3）。大多数手术是为恶性疾病进行的（81.3％），最常见的手术是前切除术（79.4％）。手术中位持续时间为 135 分钟（范围 65 至 330 分钟），44 名患者（10.5％）转为开放手术。78 名患者（18.7％）发生并发症，包括 5 名（1.20％）吻合口漏。中位住院时间为 5 天（范围 3 至 90 天），中位随访时间为 19 个月（范围 1 至 46 个月）。在 340 名患有恶性疾病的患者中，中位淋巴结检出数为 13 个（范围 5 至 48 个），在最新的复查中，230 名患者（67.6％）无疾病，局部区域复发率为 2.9％，全身复发率为 10％。
迄今为止，这是本地报告的最大系列腹腔镜结直肠切除术，我们的结果表明，该手术安全、可行，效果良好。
