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单孔腹腔镜结肠切除术:IV期结肠癌的病例对照研究

Single-Incision Laparoscopic Colectomy: A Case Match Study for Stage IV Colon Cancer.

作者信息

Hirano Yasumitsu, Hattori Masakazu, Douden Kenji

机构信息

Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan.

出版信息

Dig Surg. 2017;34(3):216-219. doi: 10.1159/000450684. Epub 2016 Dec 10.

Abstract

BACKGROUND

Utilization of single-incision laparoscopic surgery for the management of colon cancer has increased; however, the feasibility of single-incision laparoscopic colectomy (SILC) for patients with stage IV colon cancer (ST4) has not been well examined.

METHODS

Fifty-four patients with ST4 could be identified who electively underwent single-incision laparoscopic surgery. In a matched pairs design, 54 patients were then chosen out of a collective of 275 patients undergoing single-incision laparoscopic surgery for stages 0-III colon cancer (ST0-3). Short-term clinical outcomes were assessed, and the overall survival status in ST4 patients was assessed.

RESULTS

The mean length of skin incision was 2.85 cm, and the median operating time and estimated blood loss were 156.1 min and 50.5 g respectively. The mean number of harvested lymph nodes was 20.7. All differences between short-time outcomes were not significant in both groups. The postoperative complication rate was significantly higher and postoperative hospital stay was significantly longer in ST4 patients. The 1-year overall survival rate was 78.5% in ST4 patients. In patients with complication, only postoperative stay was significantly prolonged compared with patients without complication.

CONCLUSIONS

Our study indicated mid-term oncological and clinical safety of SILC for patients with ST4.

摘要

背景

单切口腹腔镜手术在结肠癌治疗中的应用有所增加;然而,单切口腹腔镜结肠切除术(SILC)用于IV期结肠癌(ST4)患者的可行性尚未得到充分研究。

方法

确定了54例择期接受单切口腹腔镜手术的ST4患者。采用配对设计,然后从275例接受0-III期结肠癌(ST0-3)单切口腹腔镜手术的患者中选出54例患者。评估短期临床结局,并评估ST4患者的总体生存状况。

结果

皮肤切口平均长度为2.85 cm,中位手术时间和估计失血量分别为156.1分钟和50.5克。平均清扫淋巴结数为20.7个。两组短期结局的所有差异均无统计学意义。ST4患者术后并发症发生率显著更高,术后住院时间显著更长。ST4患者1年总生存率为78.5%。有并发症的患者与无并发症的患者相比,仅术后住院时间显著延长。

结论

我们的研究表明SILC用于ST4患者具有中期肿瘤学和临床安全性。

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