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腹腔镜结肠癌切除术的短期疗效。

Short-term outcomes following laparoscopic resection for colon cancer.

机构信息

Division of Colorectal Surgery, Adelaide and Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland.

出版信息

Int J Colorectal Dis. 2011 Mar;26(3):361-8. doi: 10.1007/s00384-010-1069-4. Epub 2010 Oct 23.

Abstract

BACKGROUND

Laparoscopic resection for colon cancer has been proven to have a similar oncological efficacy compared to open resection. Despite this, it is performed by a minority of colorectal surgeons. The aim of our study was to evaluate the short-term clinical, oncological and survival outcomes in all patients undergoing laparoscopic resection for colon cancer.

METHODS

From July 2005 to December 2008, 202 consecutive patients underwent laparoscopic resection for colon cancer. Surgery was analysed on an intention to treat basis. The mean follow-up was 24.3 months.

RESULTS

Two hundred twenty-two patients underwent resection for colon cancer. Two hundred two underwent laparoscopic resection (91%). One hundred sixteen were male patients. Mean age was 65.9 years (range = 24-91). The median length of stay was 6.6 days (mean = 7.1 days). One hundred eighty-eight of 202 (93.1%) were completed laparoscopically. Fourteen (6.9%) were converted. The overall morbidity rate was 15.8%. There were three clinically apparent anastomotic leaks. The 30-day mortality was 1 (0.5%). The mean nodal yield was 13.4 (range = 8-37) nodes. There were no positive margins detected. Overall survival in laparoscopically treated colon cancer was 88.1%. In those patients with non-metastatic disease, the overall survival was 90.7% (165/182).

CONCLUSION

Laparoscopic resection for colon cancer is achievable in 85% (188/222) of patients. This facilitates adequate oncological clearance. It is associated with a low morbidity rate and favourable short-term survival outcomes. This data reflects the potential outcomes dedicated MIS colorectal units will have to offer colon cancer patients once laparoscopic colorectal surgery becomes the de facto surgical approach.

摘要

背景

腹腔镜结直肠癌切除术已被证明与开放切除术具有相似的肿瘤学疗效。尽管如此,它仅由少数结直肠外科医生实施。我们的研究旨在评估所有接受腹腔镜结直肠癌切除术患者的短期临床、肿瘤学和生存结局。

方法

2005 年 7 月至 2008 年 12 月,202 例连续患者接受腹腔镜结直肠癌切除术。手术基于意向治疗进行分析。平均随访时间为 24.3 个月。

结果

222 例患者接受结直肠癌切除术。202 例行腹腔镜切除术(91%)。116 例为男性患者。平均年龄为 65.9 岁(范围=24-91 岁)。中位住院时间为 6.6 天(平均=7.1 天)。202 例中有 188 例(93.1%)完全腹腔镜完成。14 例(6.9%)中转开腹。总发病率为 15.8%。有 3 例明显的吻合口漏。30 天死亡率为 1(0.5%)。平均淋巴结检出数为 13.4(范围=8-37)枚。无阳性切缘。腹腔镜治疗的结肠癌总生存率为 88.1%。在无转移疾病的患者中,总生存率为 90.7%(165/182)。

结论

腹腔镜结直肠癌切除术在 85%(188/222)的患者中是可行的。这有利于充分的肿瘤清除。它与低发病率和良好的短期生存结局相关。一旦腹腔镜结直肠手术成为事实上的手术方法,这些数据反映了专门的微创外科结直肠单位为结肠癌患者提供的潜在结果。

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