Tajima Takayuki, Mukai Masaya, Yokoyama Daiki, Higami Shigeo, Uda Shuji, Hasegawa Sayuri, Nomura Eiji, Sadahiro Sotaro, Yasuda Seiei, Makuuchi Hiroyasu
Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan.
Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Oncol Lett. 2017 Jun;13(6):4953-4958. doi: 10.3892/ol.2017.6035. Epub 2017 Apr 13.
In recent years, the use of laparoscopic surgery has been expanded to include radical curative resection. In a previous study, 212 patients with primary colorectal cancer (stages I-III) underwent radical curative resection by hand-assisted laparoscopic surgery (HALS) (n=98) or conventional laparotomy (CL) (n=114) and were compared with respect to 3-year relapse-free survival (3Y-RFS) and 3-year overall survival (3Y-OS). The study included 210/212 patients who were followed up to 5 years, including 96 patients who underwent HALS and 114 treated with CL. The two groups were matched for stage, clinical background, and postoperative management. Patient characteristics were compared and the 5Y-RFS and 5Y-OS were determined. The 5-year follow-up rate was 97.6%. In stage I-III patients, 5Y-RFS and 5Y-OS showed no significant differences between HALS and CL. The patients with stage I disease accounted for 41.7% (40/96) of the patients undergoing HALS, while stage I patients only accounted for 23.7% (27/114) of the patients undergoing CL, and the difference was significant (P=0.005). Stage II patients undergoing CL were older than those treated with HALS (P=0.017). However, there were no differences in the characteristics of stage III patients undergoing HALS or CL. In conclusion, HALS achieved a similar survival to CL in patients with stage I to III colorectal cancer. Compared with CL, HALS was performed more safely and achieved superior cosmetic results.
近年来，腹腔镜手术的应用范围已扩大到包括根治性切除。在一项先前的研究中，212例原发性结直肠癌（I - III期）患者接受了手辅助腹腔镜手术（HALS）（n = 98）或传统开腹手术（CL）（n = 114），并就3年无复发生存率（3Y - RFS）和3年总生存率（3Y - OS）进行了比较。该研究纳入了210/212例随访至5年的患者，其中96例接受了HALS，114例接受了CL治疗。两组在分期、临床背景和术后管理方面进行了匹配。比较了患者特征并确定了5Y - RFS和5Y - OS。5年随访率为97.6%。在I - III期患者中，HALS和CL之间的5Y - RFS和5Y - OS无显著差异。I期疾病患者占接受HALS患者的41.7%（40/96），而I期患者仅占接受CL患者的23.7%（27/114），差异有统计学意义（P = 0.005）。接受CL治疗的II期患者比接受HALS治疗的患者年龄更大（P = 0.017）。然而，接受HALS或CL治疗的III期患者在特征方面没有差异。总之，在I至III期结直肠癌患者中，HALS与CL的生存率相似。与CL相比，HALS手术更安全，美容效果更佳。
