Matsuda Takeru, Fujita Hirofumi, Kunimoto Yukihiro, Kimura Taisei, Hayashi Tomomi, Maeda Toshiyuki, Yamakawa Junichi, Mizumoto Takuya, Ogino Kazunori
Department of Surgery, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Asian J Endosc Surg. 2013 Aug;6(3):186-91. doi: 10.1111/ases.12017. Epub 2013 Jan 17.
The feasibility, safety and oncological outcomes of laparoscopic surgery for transverse and descending colon cancers in a community hospital setting were evaluated.
Twenty-six patients with transverse or descending colon cancers who underwent laparoscopic surgery at our hospital were included in this retrospective analysis (group A). Their outcomes were compared with those of 71 patients who underwent laparoscopic surgery for colon cancer at other tumor sites (group B).
There were no significant differences between the two groups in terms of operative time, estimated blood loss, postoperative hospital stay and morbidity rate. Extended lymphadenectomy was performed more frequently and the number of harvested lymph nodes was significantly higher in group B than in group A. However, no recurrence developed in group A, while recurrence occurred in four patients from group B. The 3-year disease-free survival rates were 100% for group A and 93.5% for group B. The 3-year overall survival rates were 100% for group A and 91.6% for group B.
Laparoscopic surgery for transverse and descending colon cancers can be performed safely with oncological validity in a community hospital setting, provided there is careful selection of the patients and adequate lymphadenectomy considering the clinical stage of their disease.
评估了在社区医院环境下腹腔镜手术治疗横结肠癌和降结肠癌的可行性、安全性及肿瘤学结局。
本回顾性分析纳入了我院26例接受腹腔镜手术的横结肠癌或降结肠癌患者（A组）。将他们的结局与71例在其他肿瘤部位接受腹腔镜结肠癌手术的患者（B组）进行比较。
两组在手术时间、估计失血量、术后住院时间和发病率方面无显著差异。B组比A组更频繁地进行扩大淋巴结清扫术，且B组收获的淋巴结数量显著多于A组。然而，A组无复发，而B组有4例患者复发。A组3年无病生存率为100%，B组为93.5%。A组3年总生存率为100%，B组为91.6%。
在社区医院环境下，只要仔细选择患者并根据疾病临床分期进行充分的淋巴结清扫，腹腔镜手术治疗横结肠癌和降结肠癌可安全实施且具有肿瘤学有效性。
