Wang Yong, Zhang Chuan, Feng Yi-Fei, Fu Zan, Sun Yue-Ming
Department of Colorectal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Chin Clin Oncol. 2017 Feb;6(1):6. doi: 10.21037/cco.2017.01.01.
Colorectal cancer (CRC) is the third most common cancer worldwide. Although laparoscopic-assisted complete mesocolic excision (LCME) is a superior treatment, there are few studies available on it owe to the low incidence and technical difficulty of LCME in transverse colon cancer.
The clinical data of 78 patients with transverse colon cancer who were treated by LCME and open complete mesocolic excision (OCME) were retrospectively analyzed. A total of 39 cases had been treated by LCME, compared with 39 cases treated by OCME. The patient characteristics and short-term outcomes including operation time, intra-operative blood loss, length of incision, time to first flatus, first postoperative ambulation, postoperative hospitalization time, number of harvested lymph nodes, length of resected specimen and incidence of complications were evaluated.
There was no case converted to OCME in LCME group. LCME had significantly shorter length of incision, shorter operation time, less intra-operative blood loss, shorter postoperative hospitalization time (P<0.05). The length of resected specimen and the numbers of harvested lymph nodes were (26.5±5.4 cm) and (16.2±3.1) in LCME group, and (24.8±4.9 cm) and (15.1±3.5) in OCME group, with no differences between two groups. The incidence of wound infection was lower while the incidence of lymphatic leakage, anastomotic leakage, urinary tract infection and wound dehiscence had no significant differences between two groups. None of patients in these two groups developed urinary retention, anastomotic bleeding and postoperative intestinal obstruction.
Our findings suggested that LCME is a safe, feasible and effective treatment method for the treatment of transverse colon cancer due to it can provide superior short-term outcomes including less intra-operative blood loss, faster recovery and lower incidence of wound infection.
结直肠癌（CRC）是全球第三大常见癌症。尽管腹腔镜辅助全结肠系膜切除术（LCME）是一种更优的治疗方法，但由于横结肠癌中LCME的发病率低且技术难度大，关于它的研究很少。
回顾性分析78例接受LCME和开放全结肠系膜切除术（OCME）治疗的横结肠癌患者的临床资料。其中39例接受LCME治疗，与39例接受OCME治疗的患者进行比较。评估患者特征和短期结局，包括手术时间、术中出血量、切口长度、首次排气时间、术后首次下床活动时间、术后住院时间、收获的淋巴结数量、切除标本长度和并发症发生率。
LCME组无病例转为OCME。LCME组的切口长度明显更短、手术时间更短、术中出血量更少、术后住院时间更短（P<0.05）。LCME组切除标本长度和收获的淋巴结数量分别为（26.5±5.4 cm）和（16.2±3.1），OCME组分别为（24.8±4.9 cm）和（15.1±3.5），两组之间无差异。伤口感染发生率较低，而淋巴漏、吻合口漏、尿路感染和伤口裂开发生率两组之间无显著差异。这两组患者均未发生尿潴留、吻合口出血和术后肠梗阻。
我们的研究结果表明，LCME是治疗横结肠癌的一种安全、可行且有效的治疗方法，因为它可以提供更优的短期结局，包括术中出血量更少、恢复更快和伤口感染发生率更低。
