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腹腔镜与开腹完整结肠系膜切除术治疗右半结肠癌的比较。

Comparison of laparoscopic versus open complete mesocolic excision for right colon cancer.

机构信息

Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, GuangZhou, 510630, China.

Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, GuangZhou, 510630, China.

出版信息

Int J Surg. 2015 Nov;23(Pt A):12-7. doi: 10.1016/j.ijsu.2015.08.037. Epub 2015 Aug 28.

Abstract

AIM

To explore the feasibility, safety, efficacy, and short-term oncologic outcomes of laparoscopic-assisted complete mesocolic excision (CME) for right colon cancer.

METHODS

The clinical data from 102 patients with right colon cancer who underwent laparoscopic CME (n = 53; LS group) and open CME (n = 49; OS group) from June 2012 to December 2013 were retrospectively reviewed. Outcomes of the two groups were compared.

RESULTS

There were no conversions to open surgery in the LS group. The operative time in the LS group was similar to that in the OS group (194 ± 57 vs. 177 ± 51 min, respectively, p = 0.118). Intraoperative blood loss was significantly less in the LS group compared with the OS group (94 ± 56 vs. 118 ± 60 ml, respectively, p = 0.039). There was no difference in the total number of harvested lymph nodes (14 ± 6 vs. 13 ± 5, respectively, p = 0.313). The time to resume liquid diet (3 ± 2 vs. 5 ± 2 d, p < 0.001) and length of hospital stay (11 ± 4 vs. 14 ± 6 d, p = 0.002) were significantly shorter in the LS group. The rate of complications was similar between the groups (4% vs. 12%, respectively, p = 0.222). No recurrences were noted in either group during follow-up (range, 6-24 months).

CONCLUSION

Laparoscopic CME is a safe, feasible, and effective minimally invasive procedure for right colon cancer.

摘要

目的

探讨腹腔镜辅助完整结肠系膜切除术(CME)治疗右半结肠癌的可行性、安全性、疗效和短期肿瘤学结果。

方法

回顾性分析 2012 年 6 月至 2013 年 12 月接受腹腔镜 CME(n = 53;LS 组)和开腹 CME(n = 49;OS 组)治疗的 102 例右半结肠癌患者的临床资料。比较两组患者的手术结果。

结果

LS 组无中转开腹手术。LS 组的手术时间与 OS 组相似(分别为 194 ± 57 分钟和 177 ± 51 分钟,p = 0.118)。LS 组术中出血量明显少于 OS 组(分别为 94 ± 56 毫升和 118 ± 60 毫升,p = 0.039)。两组淋巴结清扫总数无差异(分别为 14 ± 6 枚和 13 ± 5 枚,p = 0.313)。LS 组恢复液体饮食的时间(3 ± 2 天 vs. 5 ± 2 天,p < 0.001)和住院时间(11 ± 4 天 vs. 14 ± 6 天,p = 0.002)均明显缩短。两组并发症发生率相似(分别为 4%和 12%,p = 0.222)。随访期间两组均未发现复发(随访时间 6-24 个月)。

结论

腹腔镜 CME 是治疗右半结肠癌安全、可行、有效的微创方法。

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