晚期低位直肠癌腹腔镜侧方盆腔淋巴结清扫术的临床及肿瘤学结局：单中心经验
Clinical and Oncological Outcomes of Laparoscopic Lateral Pelvic Lymph Node Dissection in Advanced Lower Rectal Cancer: Single-institution Experience.
作者信息
Nonaka Takashi, Fukuda Akiko, Maekawa Kyoichiro, Nagayoshi Shigeki, Tokunaga Takayuki, Takatsuki Mitsutoshi, Kitajima Tomoo, Taniguchi Ken, Fujioka Hikaru
机构信息
Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
出版信息
Anticancer Res. 2017 Sep;37(9):5095-5100. doi: 10.21873/anticanres.11927.
AIM
The aim of this study was to compare the clinical outcomes of laparoscopic versus open surgery for total mesorectal excision (TME) with lateral pelvic lymph node dissection (LPLD) in advanced lower rectal cancer.
PATIENTS AND METHODS
Forty-four patients who underwent TME with LPLD for lower rectal cancer (pStage II/III) between January 2008 and December 2014 were divided into two groups according to the type of surgical approach as follows: open LPLD group (OLD, n=17) and laparoscopic LPLD group (LLD, n=27).
RESULTS
Operative time was comparable between the groups (p=0.15), whereas intraoperative blood loss and complication rates were significantly less in LLD than in OLD. Postoperative hospital stay was shorter in LLD than in OLD. Overall survival and local recurrence-free survival were similar in the two groups. Disease-free survival was better in LLD than in OLD, although the difference was not significant.
CONCLUSION
Laparoscopic TME with LPLD is safe and feasible.
目的
本研究旨在比较腹腔镜与开放手术行全直肠系膜切除（TME）联合侧方盆腔淋巴结清扫（LPLD）治疗晚期低位直肠癌的临床疗效。
患者与方法
2008年1月至2014年12月期间，44例行TME联合LPLD治疗低位直肠癌（p分期II/III期）的患者，根据手术方式分为两组：开放LPLD组（OLD，n = 17）和腹腔镜LPLD组（LLD，n = 27）。
结果
两组手术时间相当（p = 0.15），而LLD组术中出血量和并发症发生率明显低于OLD组。LLD组术后住院时间短于OLD组。两组总生存率和局部无复发生存率相似。LLD组无病生存率优于OLD组，尽管差异不显著。
结论
腹腔镜TME联合LPLD安全可行。
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