Marco Braga, Nicolò Pecorelli, Matteo Frasson, Andrea Vignali, Walter Zuliani, Valerio Di Carlo, Department of Surgery, San Raffaele University, 20132 Milan, Italy.
World J Gastrointest Oncol. 2011 Mar 15;3(3):43-8. doi: 10.4251/wjgo.v3.i3.43.
To evaluate long-term outcomes in a large series of patients who randomly received laparoscopic or open colorectal resection.
From February 2000 to December 2004, six hundred sixty-two patients with colorectal disease were randomly assigned to laparoscopic (LPS, n = 330) or open (n = 332) colorectal resection. All patients were analyzed on an intention-to-treat basis. Long-term follow-up was carried out every 6 mo by office visits. In 526 cancer patients five-year overall and disease-free survival were evaluated. Median oncologic follow-up was 96 mo.
Eight (4.2%) LPS group patients needed conversion to open surgery. Overall long-term morbidity rate was 7.6% (25/330) in the LPS vs 11.1% (37/332) in the open group (P = 0.17). In cancer patients, five-year overall survival was 68.6% in the LPS group and 64.0% in the Open group (P = 0.27). Excluding stage IV patients, five-year local and distant recurrence rates were 32.5% in the LPS group and 36.8% in the Open group (P = 0.36). Further, no difference in recurrence rate was found when patients were stratified according to cancer stage.
LPS colorectal resection was associated with a slightly lower incidence of long-term complications than open surgery. No difference between groups was found in overall and disease-free survival rates.
评估一组随机接受腹腔镜或开腹结直肠切除术的患者的长期结果。
从 2000 年 2 月至 2004 年 12 月，662 例结直肠疾病患者被随机分配接受腹腔镜（LPS，n = 330）或开腹（n = 332）结直肠切除术。所有患者均进行意向治疗分析。通过门诊随访进行长期随访，每 6 个月进行一次。在 526 例癌症患者中，评估了 5 年的总生存率和无病生存率。中位肿瘤随访时间为 96 个月。
LPS 组有 8 例（4.2%）患者需要转为开腹手术。LPS 组的总体长期发病率为 7.6%（25/330），开腹组为 11.1%（37/332）（P = 0.17）。在癌症患者中，LPS 组的 5 年总生存率为 68.6%，开腹组为 64.0%（P = 0.27）。排除 IV 期患者后，LPS 组和开腹组的 5 年局部和远处复发率分别为 32.5%和 36.8%（P = 0.36）。此外，根据癌症分期对患者进行分层后，复发率无差异。
LPS 结直肠切除术与开腹手术相比，长期并发症的发生率略低。两组患者的总生存率和无病生存率无差异。
