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脾曲结肠癌腹腔镜手术的长期肿瘤学结局与传统开放手术相当。

Long-term oncologic outcomes of laparoscopic surgery for splenic flexure colon cancer are comparable to conventional open surgery.

作者信息

Kim Min Ki, Lee In Kyu, Kang Won-Kyung, Cho Hyeon-Min, Kye Bong-Hyeon, Jalloun Heba Essam, Kim Jun-Gi

机构信息

Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2017 Jul;93(1):35-42. doi: 10.4174/astr.2017.93.1.35. Epub 2017 Jun 26.

Abstract

PURPOSE

Few studies about laparoscopic surgery for splenic flexure colon cancer have been published. This study aims to compare the short- and long-term outcomes of laparoscopic surgery for splenic flexure colon cancer with those of conventional open surgery.

METHODS

From January 2004 to December 2010, 51 consecutive patients who underwent curative resection for stages I-III splenic flexure colon cancer were enrolled. Thirty-three patients underwent laparoscopy-assisted colectomy, while 18 patients underwent conventional open colectomy. Short- and long-term outcomes of the 2 groups were compared.

RESULTS

There were no differences in baseline characteristics, intra- and postoperative complications. The laparoscopy group showed longer operation time (median [interquartile range, IQR]: 295.0 [255.0-362.5] minutes . 180.0 [168.8-206.3] minutes, P < 0.001). In the laparoscopy group, return of bowel function was faster (median [IQR]: 3 [2-4] . 4 [3-5], P = 0.007) and postoperative hospital stay was shorter (median [IQR]: 9 [8-11] . 10.5 [9-19], P = 0.026). There were no statistically significant differences in overall survival rate (84.3% . 76.0%, P = 0.560) or disease-free survival rate (93.8% . 74.5%, P = 0.078) between the 2 groups.

CONCLUSION

Laparoscopic surgery for splenic flexure colon cancer has better short-term outcomes than open surgery, as well as acceptable long-term outcomes. Laparoscopic surgery can be a safe and feasible alternative to conventional open surgery for splenic flexure colon cancer.

摘要

目的

关于腹腔镜手术治疗脾曲结肠癌的研究报道较少。本研究旨在比较腹腔镜手术与传统开放手术治疗脾曲结肠癌的短期和长期疗效。

方法

选取2004年1月至2010年12月期间连续51例行I - III期脾曲结肠癌根治性切除术的患者。33例患者接受腹腔镜辅助结肠切除术,18例患者接受传统开放结肠切除术。比较两组患者的短期和长期疗效。

结果

两组患者的基线特征、术中及术后并发症无差异。腹腔镜组手术时间较长(中位数[四分位间距,IQR]:295.0[255.0 - 362.5]分钟 对 180.0[168.8 - 206.3]分钟,P < 0.001)。腹腔镜组肠道功能恢复更快(中位数[IQR]:3[2 - 4]天 对 4[3 - 5]天,P = 0.007),术后住院时间更短(中位数[IQR]:9[8 - 11]天 对 10.5[9 - 19]天,P = 0.026)。两组患者的总生存率(84.3% 对 76.0%,P = 0.560)或无病生存率(93.8% 对 74.5%,P = 0.078)无统计学显著差异。

结论

腹腔镜手术治疗脾曲结肠癌较开放手术具有更好的短期疗效,长期疗效也可接受。腹腔镜手术可作为脾曲结肠癌传统开放手术的一种安全可行的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d176/5507789/7f289493ab95/astr-93-35-g001.jpg

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