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腹腔镜下结直肠癌切除术及同期肝转移灶切除术:一项病例对照研究。

Laparoscopic resections of colorectal cancer and synchronous liver metastases: a case controlled study.

作者信息

Xu Xiao, Guo Yulin, Chen Guijin, Li Chen, Wang Hongguang, Dong Guanglong

机构信息

a Department of General Surgery , Chinese PLA General Hospital , Beijing , China.

b Department of General Surgery , The First Affiliated Hospital of Dalian Medical University , Dalian , Liaoning , China.

出版信息

Minim Invasive Ther Allied Technol. 2018 Aug;27(4):209-216. doi: 10.1080/13645706.2017.1378236. Epub 2017 Sep 19.

Abstract

PURPOSE

To investigate the efficacy and safety of laparoscopic simultaneous resections of colorectal cancer and synchronous colorectal liver metastases (SCRLM), relative to open surgery.

METHODS

Between 1 January 2009 and 20 April 2014, 20 of 25 patients who underwent laparoscopic simultaneous colorectal cancer and SCRLM resections were matched with 20 of 29 patients who underwent an open approach, based on prognostic propensity scores. Perioperative results and survival outcomes were compared.

RESULTS

The laparoscopic and open groups were comparable in demographics, cancer characteristics, surgery characteristics, and chemotherapy treatment. No postoperative mortality occurred in either group. The estimated blood loss and postoperative stay were significantly greater in the open group than in the laparoscopic group (all, p < .05). All other perioperative results and postoperative complications were similar between the two groups, as well as three-year overall and disease-free survival rates.

CONCLUSIONS

The postoperative complications and survival rates of patients given laparoscopic simultaneous colorectal cancer and SCRLM resections were similar to those treated with an open approach, but with greater short-term benefits. Laparoscopy in this setting by an experienced surgical team appears safe and effective, and is a feasible alternative to an open approach for selected patients.

摘要

目的

探讨腹腔镜同期切除结直肠癌及同时性结直肠癌肝转移(SCRLM)相对于开放手术的疗效和安全性。

方法

在2009年1月1日至2014年4月20日期间,根据预后倾向评分,对25例行腹腔镜同期结直肠癌及SCRLM切除的患者中的20例,与29例行开放手术的患者中的20例进行匹配。比较围手术期结果和生存结局。

结果

腹腔镜组和开放组在人口统计学、癌症特征、手术特征和化疗治疗方面具有可比性。两组均未发生术后死亡。开放组的估计失血量和术后住院时间显著高于腹腔镜组(均P < 0.05)。两组的所有其他围手术期结果和术后并发症相似,三年总生存率和无病生存率也相似。

结论

接受腹腔镜同期结直肠癌及SCRLM切除的患者的术后并发症和生存率与接受开放手术的患者相似,但具有更大的短期益处。由经验丰富的手术团队在此情况下进行腹腔镜手术似乎是安全有效的,并且对于选定的患者是开放手术的可行替代方案。

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