Tajima Takayuki, Mukai Masaya, Yamazaki Masashi, Higami Shigeo, Yamamoto Souichirou, Hasegawa Sayuri, Nomura Eiji, Sadahiro Sotaro, Yasuda Seiei, Makuuchi Hiroyasu
Department of Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan.
Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Oncol Lett. 2014 Aug;8(2):627-632. doi: 10.3892/ol.2014.2182. Epub 2014 May 27.
The present study aimed to compare the results of hand-assisted laparoscopic surgery (HALS) and conventional laparotomy (CL) at a single institution in Japan. Of the 212 patients with stage I/II/III colorectal cancer who received a curative resection, 98 patients underwent HALS and 114 patients underwent CL. The clinical background and post-operative management did not differ between the two groups. There were no significant differences in the 3-year relapse-free and 3-year overall survival rates between the HALS and CL groups for the patients in any stage. Blood loss during surgery was 250.1 and 135.5 ml (mean and median; the same hereafter) in stage I patients receiving HALS versus 608.2 and 315.5 ml in stage I CL patients (P=0.006), while it was 277.6 and 146 ml in stage II patients receiving HALS versus 548.6 and 347 ml in stage II CL patients (P=0.004). Post-operative hospital stay was recorded at 16.8 and 15 days in stage III patients receiving HALS versus 23.1 and 21 days in stage III CL patients (P=0.001). There were no significant differences in the operating time or complications between the two groups. These results indicate that the survival rate was comparable for HALS and CL, while HALS caused less surgical stress and achieved a better cosmetic outcome. The results of the final analysis of this cohort are awaited.
本研究旨在比较日本一家机构中手辅助腹腔镜手术（HALS）和传统开腹手术（CL）的结果。在212例接受根治性切除的I/II/III期结直肠癌患者中，98例行HALS，114例行CL。两组的临床背景和术后管理无差异。在任何分期的患者中，HALS组和CL组的3年无复发生存率和3年总生存率均无显著差异。I期接受HALS手术的患者术中失血量为250.1和135.5 ml（均值和中位数；下同），而I期CL患者为608.2和315.5 ml（P = 0.006）；II期接受HALS手术的患者术中失血量为277.6和146 ml，而II期CL患者为548.6和347 ml（P = 0.004）。III期接受HALS手术的患者术后住院时间记录为16.8和15天，而III期CL患者为23.1和21天（P = 0.001）。两组的手术时间或并发症无显著差异。这些结果表明，HALS和CL的生存率相当，而HALS引起的手术应激较小，美容效果更好。该队列最终分析的结果有待观察。
