Department of Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan,
Surg Endosc. 2014 Jan;28(1):80-4. doi: 10.1007/s00464-013-3165-3. Epub 2013 Aug 31.
With the progress of surgical techniques and devices, laparoscopic hepatectomy (Lap-Hx) became a realizable option for patients with liver tumors. However, the feasibility of Lap-Hx for metastatic liver tumor of colorectal cancer also should be guaranteed oncologically. This study evaluated the short- and long-term outcomes of Lap-Hx compared with open hepatectomy (Open-Hx) for patients with colorectal liver metastasis (CLM) by matched-pair analysis.
This study enrolled 21 patients who underwent Lap-Hx and compared them with 21 matched patients who underwent Open-Hx. The following parameters were matched between the two cohorts: tumor size, tumor location, and operative procedures. Both short- and long-term outcomes of Lap-Hx were compared with those of Open-Hx.
No difference was observed between the two groups in terms of age, gender, tumor size, or operative procedures. With regard to short-term outcomes, the operative time for Lap-Hx (377 ± 29 min) was similar to that for Open-Hx (369 ± 31 min), whereas the blood loss for the patients who underwent a Lap-Hx (198 ± 39 ml) was significantly less than for those who underwent an Open-Hx (326 ± 50 ml). The incidence of postoperative complications among the patients who underwent Lap-Hx tended to be lower than for the patients who underwent Open-Hx, and intraabdominal abscess was observed only in the Open-Hx group. The hospital stay for Lap-Hx (average, 18.3 days) tended to be shorter than for Open-Hx (27 days). With respect to long-term outcomes, the two groups did not differ significantly in terms of 5-year overall and disease-free survival rates.
Lap-Hx is a safe and feasible option for selected patients with CLM. The short- and long-term outcomes of Lap-Hx also are considered to be acceptable.
随着手术技术和设备的进步，腹腔镜肝切除术（Lap-Hx）已成为肝脏肿瘤患者的可行选择。然而，对于结直肠癌肝转移（CLM）患者，Lap-Hx 的可行性也应在肿瘤学上得到保证。本研究通过配对分析评估了与开腹肝切除术（Open-Hx）相比，Lap-Hx 治疗结直肠癌肝转移患者的短期和长期结果。
本研究纳入了 21 例接受 Lap-Hx 的患者，并与 21 例接受 Open-Hx 的匹配患者进行比较。两组患者在肿瘤大小、肿瘤位置和手术方式等方面进行了匹配。比较了 Lap-Hx 和 Open-Hx 的短期和长期结果。
两组患者在年龄、性别、肿瘤大小或手术方式方面无差异。在短期结果方面，Lap-Hx 的手术时间（377±29 分钟）与 Open-Hx 相似（369±31 分钟），而 Lap-Hx 组患者的出血量（198±39 毫升）明显少于 Open-Hx 组（326±50 毫升）。Lap-Hx 组患者术后并发症的发生率低于 Open-Hx 组，且仅在 Open-Hx 组中观察到腹腔脓肿。Lap-Hx 的住院时间（平均 18.3 天）倾向于短于 Open-Hx（27 天）。在长期结果方面，两组患者的 5 年总生存率和无病生存率无显著差异。
对于选定的 CLM 患者，Lap-Hx 是一种安全可行的选择。Lap-Hx 的短期和长期结果也被认为是可以接受的。
