腹腔镜下直肠癌根治术后侧方盆腔淋巴结清扫术的临床可行性研究
Clinical feasibility of laparoscopic lateral pelvic lymph node dissection following total mesorectal excision for advanced rectal cancer.
作者信息
Furuhata Tomohisa, Okita Kenji, Nishidate Toshihiko, Ito Tatsuya, Yamaguchi Hiroshi, Ueki Tomomi, Akizuki Emi, Meguro Makoto, Ogawa Tadashi, Kukita Kazuharu, Kimura Yasutoshi, Mizuguchi Toru, Hirata Koichi
机构信息
Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo, Japan,
出版信息
Surg Today. 2015 Mar;45(3):310-4. doi: 10.1007/s00595-014-0906-4. Epub 2014 May 3.
PURPOSE
To evaluate the technical feasibility, safety and oncological outcomes of laparoscopic lateral pelvic lymph node dissection in patients with advanced low rectal cancer.
METHODS
Laparoscopic lateral pelvic lymph node dissection was performed in 18 patients from November 2009 to September 2012. The data regarding the patient demographics, surgical outcomes and short-term oncological outcomes were analyzed.
RESULTS
In all 18 patients, the procedures were completed without conversion to open surgery. The mean length of the operation was 603.7 min (473-746 min). The mean number of harvested lateral pelvic lymph nodes was 16.9 (7-27), and five patients (27.8 %) had lymph node metastases. The postoperative mortality and morbidity rates were 0 and 16.7 %, respectively. Three patients developed Grade 2 urinary retention. No local recurrence had developed after a mean follow-up period of 23.6 months.
CONCLUSION
Laparoscopic lateral pelvic lymph node dissection is technically feasible, safe and oncologically acceptable within the limitations of the short-term follow-up period.
目的
评估腹腔镜下低位直肠癌患者侧方盆腔淋巴结清扫术的技术可行性、安全性及肿瘤学结局。
方法
2009年11月至2012年9月，对18例患者实施了腹腔镜下侧方盆腔淋巴结清扫术。分析患者人口统计学数据、手术结局及短期肿瘤学结局。
结果
18例患者均顺利完成手术，无中转开腹。平均手术时间为603.7分钟（473 - 746分钟）。平均清扫侧方盆腔淋巴结数为16.9枚（7 - 27枚），5例患者（27.8%）有淋巴结转移。术后死亡率和发病率分别为0和16.7%。3例患者出现2级尿潴留。平均随访23.6个月后无局部复发。
结论
在短期随访的局限性范围内，腹腔镜下侧方盆腔淋巴结清扫术在技术上是可行的、安全的且在肿瘤学上是可接受的。
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