Chi Zhaocheng, Li Zhe, Cheng Longwei, Wang Can
Second Department of Gastrointestinal Surgery, Jilin Cancer Hospital, Changchun, Jilin 130012, People's Republic of China.
J BUON. 2018 Mar-Apr;23(2):322-328.
This study aimed to use propensity score matching (PSM) to compare long-term outcomes after laparoscopicassisted and open colectomy for splenic flexure cancer (SFC).
Clinical and follow-up data from 189 SFC patients undergoing colectomy at our hospital between January 2009 and January 2016 were retrospectively analyzed. According to the surgical approach employed, the patients were categorized into a laparoscopy group and an open group. The patients were matched at a ratio of 1:1 using PSM, with the match variables including gender, body mass index, clinical stage, and American Society of Anesthesiologists (ASA) score. Sixty-two patients in each group were ultimately included in this study and their short- and long-term outcomes were compared.
In contrast to the open group, the laparoscopy group had less intraoperative blood loss, faster postoperative recovery, and shorter hospitalization duration. On day 30 after surgery, there was no statistically significant difference in the incidence of minor or major complications between the two groups. The intraoperative mortality and mortality within 30 days after surgery were all 0% in the two groups. There was no statistically significant difference in pathological results between the two groups. There was no statistically significant difference in the tumor recurrence, 5-year overall survival (OS), and 5-year disease-free survival (DFS) rates between the two groups.
Laparoscopic-assisted colectomy for SFC had the same long-term outcome as open colectomy.
本研究旨在使用倾向评分匹配法(PSM)比较腹腔镜辅助与开放结肠切除术治疗脾曲癌(SFC)后的长期结局。
回顾性分析2009年1月至2016年1月在我院接受结肠切除术的189例SFC患者的临床及随访数据。根据所采用的手术方式,将患者分为腹腔镜组和开放组。采用PSM以1:1的比例对患者进行匹配,匹配变量包括性别、体重指数、临床分期和美国麻醉医师协会(ASA)评分。最终每组纳入62例患者,并比较其短期和长期结局。
与开放组相比,腹腔镜组术中出血量更少,术后恢复更快,住院时间更短。术后第30天,两组轻度或重度并发症的发生率无统计学差异。两组术中死亡率和术后30天内死亡率均为0%。两组病理结果无统计学差异。两组肿瘤复发率、5年总生存率(OS)和5年无病生存率(DFS)无统计学差异。
腹腔镜辅助结肠切除术治疗SFC与开放结肠切除术具有相同的长期结局。