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腹腔镜与开腹手术治疗结直肠癌合并同步肝转移的长期疗效比较。

Long term outcomes of simultaneous laparoscopic versus open resection for colorectal cancer with synchronous liver metastases.

机构信息

Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Taiwan; Division of General Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Taipei, Taiwan; Department of surgery, Taipei Medical University Shuang-Ho Hospital, Number 291, Zhongzheng Road, Zhonghe District, New Taipei City. 235, Taiwan.

Division of General Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Taipei, Taiwan; Department of surgery, Taipei Medical University Shuang-Ho Hospital, Number 291, Zhongzheng Road, Zhonghe District, New Taipei City. 235, Taiwan.

出版信息

Asian J Surg. 2019 Jan;42(1):217-223. doi: 10.1016/j.asjsur.2018.04.006. Epub 2018 May 25.

Abstract

BACKGROUND/OBJECTIVE: Because of the advancements in the surgical techniques of liver resection and improvements in anesthesia and postoperative critical care, the simultaneous resection of synchronous colorectal cancer with liver metastasis either by the laparoscopic procedure or by the open resection method has been considered as a safe and acceptable option. However, there is limited information on the comparison of postoperative outcomes between laparoscopic surgery and open surgery. This study investigated the clinical results and postoperative outcomes of laparoscopic simultaneous resection of synchronous colorectal cancer with liver metastasis in comparison with those of open surgery.

METHODS

Patients with synchronous colorectal cancer and liver metastasis who underwent simultaneous resection at Shuang Ho Hospital from 2009 to 2017 were identified. The patient demographics, perioperative morbidity, and survival rates were analyzed.

RESULTS

A total of 38 patients underwent simultaneous resection of synchronous colorectal cancer with liver metastasis. Laparoscopic procedure was performed for 16 patients, and the remaining 22 patients underwent open surgery. No significant differences were observed in the patient characteristics between the two groups. There was no perioperative mortality in both groups. The 1- and 3-year disease-free survival rates were 56% and 35% in the laparoscopic group and 70% and 15% in the open surgery group, respectively. The 1- and 3-year overall survival rates were 100% and 84% in the laparoscopic group and 73% and 48% in the open surgery group, respectively.

CONCLUSION

In selected patients, laparoscopic surgery for simultaneous resection of synchronous colorectal cancer with liver metastasis seems to be safe and had a similar outcome to that of open surgery.

摘要

背景/目的:由于肝切除术的手术技术进步以及麻醉和术后重症监护的改善,同时通过腹腔镜手术或开放性切除术切除同时性结直肠癌伴肝转移已被认为是一种安全且可接受的选择。然而,关于腹腔镜手术与开放性手术术后结果的比较信息有限。本研究调查了腹腔镜同时切除同时性结直肠癌伴肝转移的临床结果和术后结果,并与开放性手术进行了比较。

方法

在双和医院 2009 年至 2017 年间接受同时性结直肠癌伴肝转移同时切除的患者中确定了患者。分析了患者的人口统计学,围手术期发病率和生存率。

结果

共有 38 例患者同时接受了同时性结直肠癌伴肝转移的切除。16 例患者接受了腹腔镜手术,其余 22 例患者接受了开放性手术。两组患者的特征无显着差异。两组均无围手术期死亡。腹腔镜组的 1 年和 3 年无病生存率分别为 56%和 35%,而开放性手术组分别为 70%和 15%。腹腔镜组的 1 年和 3 年总生存率分别为 100%和 84%,而开放性手术组分别为 73%和 48%。

结论

在选择的患者中,腹腔镜手术同时切除同时性结直肠癌伴肝转移似乎是安全的,并且与开放性手术的结果相似。

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