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腹腔镜同期切除原发性肿瘤及肝转移灶治疗结直肠癌:手术技术及短期疗效

Simultaneous Laparoscopic Resection of Primary Tumor and Liver Metastases for Colorectal Cancer: Surgical Technique and Short-Term Outcome.

作者信息

Miyamoto Yuji, Beppu Toru, Sakamoto Yasuo, Imai Katsunori, Hayashi Hiromitsu, Nitta Hidetoshi, Ishiko Takatoshi, Watanabe Masayuki, Baba Hideo

出版信息

Hepatogastroenterology. 2015 Jun;62(140):846-52.

Abstract

BACKGROUND/AIMS: Laparoscopic approaches are increasingly used in selected patients with either colorectal or liver disease. The aim of this study was to evaluate the safety and feasibility of laparoscopy-assisted combined colorectal and liver resection for primary colorectal cancer (CRC) with synchronous liver metastases.

METHODOLOGY

Thirteen patients with CRC with synchronous liver metastases who underwent simultaneous laparoscopic colectomy and hepatic resection from January 2009 through July 2013 were evaluated.

RESULTS

The patients' median age was 65 years and the median body mass index was 23.7 kg/M2. The primary sites were the right colon in 4 cases, left colon in 6, and rectum in 3. Liver resections consisted of 14 partial resections or 3 left lateral hepatectomies. One patient was converted to open hepatectomy. The median surgical time was 616 (range, 200-907) min, and the median estimated blood loss was 520 (range, 70-2016) mL. Postoperative mortality did not occur. Three patients experienced minor postoperative complications: bile leakage and wound infection. The median hospital stay was 14 (range, 9-58) days.

CONCLUSIONS

This study shows that combined colon and liver resection with the laparoscopic approach is technically feasible and safe in selected patients with primary CRC and synchronous liver metastases.

摘要

背景/目的:腹腔镜手术方法越来越多地应用于部分患有结肠或肝脏疾病的患者。本研究的目的是评估腹腔镜辅助下结肠和肝脏联合切除术治疗原发性结直肠癌(CRC)合并同步肝转移的安全性和可行性。

方法

对2009年1月至2013年7月期间接受同期腹腔镜结肠切除术和肝切除术的13例原发性结直肠癌合并同步肝转移患者进行评估。

结果

患者的中位年龄为65岁,中位体重指数为23.7kg/m²。原发部位为右半结肠4例,左半结肠6例,直肠3例。肝切除包括14例部分切除术或3例左外叶肝切除术。1例患者中转开腹肝切除术。中位手术时间为616(范围200 - 907)分钟,中位估计失血量为520(范围70 - 2016)毫升。未发生术后死亡。3例患者出现轻微术后并发症:胆漏和伤口感染。中位住院时间为14(范围9 - 58)天。

结论

本研究表明,对于部分原发性结直肠癌合并同步肝转移患者,腹腔镜下结肠和肝脏联合切除术在技术上是可行且安全的。

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