Ohta Katsuya, Takemasa Ichiro, Uemura Mamoru, Nishimura Junichi, Mizushima Tsunekazu, Ikeda Masataka, Yamamoto Hirofumi, Sekimoto Mitsugu, Doki Yuichiro, Mori Masaki
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Surg Laparosc Endosc Percutan Tech. 2014 Apr;24(2):153-7. doi: 10.1097/SLE.0b013e31828f6761.
Laparoscopic surgery (Lap) is a feasible therapy in advanced colorectal cancer (CRC) without distant metastasis. Resection of primary lesion in stage IV CRC is now recognized as part of multimodal therapy. However, technical safety and invasiveness of Lap in stage IV CRC remain controversial. The feasibility of Lap in stage IV CRC was determined. Clinical outcomes were compared in primary colorectal resection using Lap, open surgery (Opn), and radical Lap for stages I to III CRC. No difference was observed regarding estimated blood loss and operative time between procedures. Postoperative recovery time and time to subsequent secondary therapy in the stage IV Lap group were significantly shorter than those in the Opn group. Similar results were observed for the 3-year overall survival rate. Lap for stage IV CRC is feasible and preferable in terms of technical safety and invasiveness. It may be useful in multimodal therapy for stage IV CRC.
腹腔镜手术（Lap）是治疗无远处转移的晚期结直肠癌（CRC）的一种可行疗法。目前，IV期结直肠癌原发灶的切除被视为多模式治疗的一部分。然而，腹腔镜手术在IV期结直肠癌中的技术安全性和侵袭性仍存在争议。本研究确定了腹腔镜手术在IV期结直肠癌中的可行性。比较了腹腔镜手术（Lap）、开放手术（Opn）以及I至III期结直肠癌根治性腹腔镜手术对原发性结直肠癌切除的临床结果。各手术方式之间在估计失血量和手术时间方面未观察到差异。IV期腹腔镜手术组的术后恢复时间和后续二次治疗时间明显短于开放手术组。3年总生存率也观察到类似结果。就技术安全性和侵袭性而言，IV期结直肠癌的腹腔镜手术是可行且更可取的。它可能对IV期结直肠癌的多模式治疗有用。
