Cao Jinpeng, Ji Yong, Peng Xiang, Wu Wenhui, Cheng Longqing, Zhou Yonghui, Yang Ping
Department of Gastrointestinal Surgery, The First People's Hospital of Foshan, Guangdong Foshan 528000, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 May 25;20(5):545-549.
To investigate the safety, feasibility and long-term outcomes of laparoscopic complete mesocolic excision for the transverse colon cancer.
Clinical data of 61 patients who underwent laparoscopic complete mesocolic excision for transverse colon cancer (transverse group) in our department from January 2011 to January 2014 were retrospectively analyzed, which were compared with those of 155 patients undergoing laparoscopic complete mesocolic excision for ascending colon cancer (ascending group) and 230 patients undergoing laparoscopic complete mesocolic excision for sigmoid colon cancer (sigmoid group). Differences in operative details, postoperative recovery, postoperative complications and long-term survival among 3 groups were evaluated.
No significant differences in the baseline information were found among 3 groups(all P>0.05). The average operative time was significantly longer in transverse group as compared to ascending group and sigmoid group (192.1±58.7) min vs. (172.2±54.7) min and (169.1±53.6) min, while the blood loss [(89.7±63.6) ml, (86.3±66.3) ml, (82.6±61.5) ml], conversion rate [3.3%(2/61), 2.6%(4/155), 2.2%(5/230)], number of harvested lymph node (13.0±4.7, 14.4±6.5, 13.4±5.6), time to flatus [(2.7±1.1) d, (2.6±1.1) d, (2.5±1.0) d], time to liquid diet [(3.0±1.7) d, (2.8±1.5) d, (2.7±1.4) d], incidence of postoperative complication(6.6%, 9.0%, 11.7%), and hospital stay [(11.6±5.8) d, (10.7±5.8) d, (10.6±5.7) d] among 3 groups were not significantly different (all P>0.05). A total of 436 patients received postoperative follow-up of median 36 (5 to 67) months. The overall 5-year survival rate was 73.1%, 73.7% and 74.8%, and the 5-year disease-free survival rate was 71.5%, 71.1% and 72.7% in transverse, ascending and sigmoid colon cancer groups respectively, whose differences were not significant among 3 groups (all P>0.05).
Laparoscopic complete mesocolic excision for transverse colon cancer is safe and feasible with slightly longer operation time, and has quite good long-term oncologic efficacy.
探讨腹腔镜全结肠系膜切除术治疗横结肠癌的安全性、可行性及长期疗效。
回顾性分析2011年1月至2014年1月在我科接受腹腔镜全结肠系膜切除术治疗的61例横结肠癌患者（横结肠组）的临床资料，并与155例接受腹腔镜全结肠系膜切除术治疗的升结肠癌患者（升结肠组）和230例接受腹腔镜全结肠系膜切除术治疗的乙状结肠癌患者（乙状结肠组）进行比较。评估三组患者手术细节、术后恢复、术后并发症及长期生存情况的差异。
三组患者基线资料差异无统计学意义（均P>0.05）。横结肠组平均手术时间显著长于升结肠组和乙状结肠组[（192.1±58.7）分钟 vs.（172.2±54.7）分钟和（169.1±53.6）分钟]（P<0.05），而三组患者术中出血量[（89.7±63.6）毫升、（86.3±66.3）毫升、（82.6±61.5）毫升]、中转率[3.3%（2/61）、2.6%（4/155）、2.2%（5/230）]、清扫淋巴结数目（13.0±4.7、14.4±6.5、13.4±5.6）、排气时间[（2.7±1.1）天、（2.6±1.1）天、（2.5±1.0）天]、进流食时间[（3.0±1.7）天、（2.8±1.5）天、（2.7±1.4）天]、术后并发症发生率（6.6%、9.0%、11.7%）及住院时间[（11.6±5.8）天、（10.7±5.8）天、（10.6±5.7）天]差异均无统计学意义（均P>0.05）。共436例患者接受术后随访，中位随访时间为36（5至67）个月。横结肠癌组、升结肠癌组和乙状结肠癌组的5年总生存率分别为73.1%、73.7%和74.8%，5年无病生存率分别为71.5%﹑71.1%和72.7%，三组差异无统计学意义（均P>0.05）。
腹腔镜全结肠系膜切除术治疗横结肠癌安全可行，手术时间稍长，长期肿瘤学疗效良好。
