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结直肠癌的单切口腹腔镜手术

Single-incision laparoscopic surgery for colorectal cancer.

作者信息

Hirano Yasumitsu, Hattori Masakazu, Douden Kenji, Ishiyama Yasuhiro, Hashizume Yasuo

机构信息

Yasumitsu Hirano, Masakazu Hattori, Kenji Douden, Yasuhiro Ishiyama, Yasuo Hashizume, Department of Surgery, Fukui Prefectural Hospital, Fukui 910-8526, Japan.

出版信息

World J Gastrointest Surg. 2016 Jan 27;8(1):95-100. doi: 10.4240/wjgs.v8.i1.95.

Abstract

AIM

To determine the effect of single-incision laparoscopic colectomy (SILC) for colorectal cancer on short-term clinical and oncological outcomes by comparison with multiport conventional laparoscopic colectomy (CLC).

METHODS

A systematic review was performed using MEDLINE for the time period of 2008 to December 2014 to retrieve all relevant literature. The search terms were "laparoscopy", "single incision", "single port", "single site", "SILS", "LESS" and "colorectal cancer". Publications were included if they were randomized controlled trials, case-matched controlled studies, or comparative studies, in which patients underwent single-incision (SILS or LESS) laparoscopic colorectal surgery. Studies were excluded if they were non-comparative, or not including surgery involving the colon or rectum. A total of 15 studies with 589 patients who underwent SILC for colorectal cancer were selected.

RESULTS

No significant differences between the groups were noted in terms of mortality or morbidity. The benefit of the SILC approach included reduction in conversion rate to laparotomy, but there were no significant differences in other short-term clinical outcomes between the groups. Satisfactory oncological surgical quality was also demonstrated for SILC for the treatment of colorectal cancer with a similar average lymph node harvest and proximal and distal resection margin length as multiport CLC.

CONCLUSION

SILC can be performed safely with similar short-term clinical and oncological outcomes as multiport CLC.

摘要

目的

通过与多端口传统腹腔镜结肠切除术(CLC)比较,确定单切口腹腔镜结肠切除术(SILC)治疗结直肠癌的短期临床和肿瘤学结局。

方法

利用MEDLINE对2008年至2014年12月期间的文献进行系统综述,以检索所有相关文献。检索词为“腹腔镜检查”“单切口”“单端口”“单部位”“SILS”“LESS”和“结直肠癌”。纳入的出版物为随机对照试验、病例匹配对照研究或比较研究,其中患者接受单切口(SILS或LESS)腹腔镜结直肠手术。如果研究为非比较性研究,或不包括涉及结肠或直肠的手术,则将其排除。共选择了15项研究,涉及589例接受SILC治疗结直肠癌的患者。

结果

两组在死亡率或发病率方面无显著差异。SILC方法的优势包括降低开腹手术转化率,但两组在其他短期临床结局方面无显著差异。SILC治疗结直肠癌的肿瘤外科手术质量也令人满意,平均淋巴结清扫数以及近端和远端切缘长度与多端口CLC相似。

结论

SILC可以安全进行,其短期临床和肿瘤学结局与多端口CLC相似。

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