Matsuda Takeru, Fujita Hirofumi, Kunimoto Yukihiro, Kimura Taisei, Kitaoka Hironori, Asano Eisuke, Hayashi Tomomi, Maeda Toshiyuki, Yamakawa Junichi, Mizumoto Takuya, Ogino Kazunori
Department of Surgery, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Hepatogastroenterology. 2012 Jul-Aug;59(117):1433-6. doi: 10.5754/hge11727.
BACKGROUND/AIMS: Similar oncological outcomes of laparoscopic and open surgery for advanced colon cancer have been reported by several large-scale studies. Whether those results are applicable to community hospitals is questionable.
From January 2007 to December 2010, 95 patients with colon cancer underwent laparoscopic surgery at Seirei Mikatahara General Hospital. Of these, 40 patients with pathological stage II/III colon cancer were subjected to this retrospective analysis (laparoscopic resection (LAP) group). Their outcomes were compared with those of 58 patients with pathological stage II/III colon cancer who underwent open surgery between January 2005 and December 2006 (open resection (OP) group).
Surgical complications were significantly less frequent in the LAP group than in the OP group. Three-year disease-free survival (DFS) and overall survival (OS) for stage II colon cancer were 88.9% and 100% in the LAP group, and 90% and 86.7% in the OP group (p=0.976 and p=0.285), respectively. Three-year DFS and OS for stage III colon cancer were 85.4% and 86.9% in the LAP group, and 75.3% and 83.8% in the OP group (p=0.613 and p=0.837), respectively.
Laparoscopic surgery for advanced colon cancer seems feasible and the oncological outcome is adequate in a community hospital setting.
背景/目的：多项大规模研究报告了腹腔镜手术和开放手术治疗晚期结肠癌的肿瘤学结局相似。这些结果是否适用于社区医院尚存在疑问。
2007年1月至2010年12月，静冈清水综合医院95例结肠癌患者接受了腹腔镜手术。其中，40例病理分期为II/III期的结肠癌患者纳入本回顾性分析（腹腔镜切除术（LAP）组）。将其结局与2005年1月至2006年12月期间接受开放手术的58例病理分期为II/III期的结肠癌患者（开放切除术（OP）组）的结局进行比较。
LAP组手术并发症的发生率显著低于OP组。II期结肠癌患者的3年无病生存率（DFS）和总生存率（OS）在LAP组分别为88.9%和100%，在OP组分别为90%和86.7%（p = 0.976和p = 0.285）。III期结肠癌患者的3年DFS和OS在LAP组分别为85.4%和86.9%，在OP组分别为75.3%和83.8%（p = 0.613和p = 0.837）。
在社区医院环境中，晚期结肠癌的腹腔镜手术似乎可行，肿瘤学结局良好。
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