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单孔腹腔镜手术治疗右半结肠癌的肿瘤学结局:倾向评分匹配分析。

Oncologic outcomes of single-incision laparoscopic surgery for right colon cancer: A propensity score-matching analysis.

机构信息

Division of Colon and Rectal Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Division of Colon and Rectal Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Int J Surg. 2017 Sep;45:125-130. doi: 10.1016/j.ijsu.2017.07.103. Epub 2017 Aug 1.

Abstract

BACKGROUND

The aim of this study was to investigate oncologic, perioperative, and pathologic outcomes of single-incision laparoscopic right hemicolectomy (SILRC) compared to conventional laparoscopic right hemicolectomy (CLRC) for right colon cancer using propensity score-matching analysis.

MATERIALS AND METHODS

From November 2009 through September 2014, 260 consecutive patients underwent laparoscopic surgery for right colon cancer. Data on short-term and long-term outcomes were collected and reviewed. Propensity score-matching was applied at a ratio of 1:2 to compare the SILRC (n = 40) and the CLRC (n = 80) groups.

RESULTS

Operation time, estimated blood loss, time to diet were not different; however, the SILRC group showed less pain on operative day and postoperative day #2 (4.8 vs. 5.9, p < 0.001 and 3.6 vs. 4.6, p = 0.006, respectively) as well as shorter incision lengths (4.0 vs. 7.3 cm, p < 0.001). Morbidity, mortality, and pathologic outcomes were similar between groups. The 3-year overall survival rates were 96.0% vs. 97.5% (p = 0.740), and disease-free survival rates were 93.5% vs. 97.5% (p = 0.444) in the SILRC and the CLRC groups, respectively.

CONCLUSION

The long-term oncologic outcomes as well as short-term outcomes of SILRC were comparable to CLRC. It appears to be a safe and feasible option with shorter incision lengths.

摘要

背景

本研究旨在通过倾向评分匹配分析,比较单切口腹腔镜右半结肠切除术(SILRC)与传统腹腔镜右半结肠切除术(CLRC)治疗右半结肠癌的肿瘤学、围手术期和病理结果。

材料与方法

2009 年 11 月至 2014 年 9 月,260 例连续患者接受腹腔镜右半结肠癌手术。收集并回顾短期和长期结果数据。应用倾向评分匹配,以 1:2 的比例比较 SILRC(n=40)和 CLRC(n=80)组。

结果

手术时间、估计出血量、饮食时间无差异;然而,SILRC 组在手术当天和术后第 2 天的疼痛程度较轻(4.8 对 5.9,p<0.001 和 3.6 对 4.6,p=0.006),切口长度较短(4.0 对 7.3cm,p<0.001)。两组的发病率、死亡率和病理结果相似。SILRC 和 CLRC 组 3 年总生存率分别为 96.0%和 97.5%(p=0.740),无病生存率分别为 93.5%和 97.5%(p=0.444)。

结论

SILRC 的长期肿瘤学结果与 CLRC 相当,短期结果也相当。它似乎是一种安全可行的选择,切口较短。

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