Hirano Yasumitsu, Hiranuma Chikashi, Hattori Masakazu, Douden Kenji, Yamaguchi Shigeki
Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan.
Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan.
ANZ J Surg. 2019 Apr;89(4):408-411. doi: 10.1111/ans.15076. Epub 2019 Mar 14.
We retrospectively reviewed our consecutive experience from the introduction of single-port laparoscopic surgery (SPS) for colon cancer, and its 5-year oncological outcomes are evaluated.
A total of 288 patients (140 males) with a mean age of 71.5 years were treated with the single-port laparoscopic colectomy for stage I, II and III colon cancers. Exclusion criteria of SPS were patients with unresolved bowel obstruction, T4b tumour, tumour perforation and severe medical illness.
In 20 patients (6.9%), we inserted an extra port mainly to transect the rectum. The median follow-up period was 52 months. The 5-year relapse-free survival rates in stage I, II and III patients were 95.8%, 80.2% and 61.6%, respectively. The 5-year overall survival rates for stage I, II and III patients were 97.4%, 85.3% and 72.9%, respectively. The 5-year cancer-specific survival rates in patients diagnosed pathologically T1, T2, T3 and T4 were 100%, 100%, 92.1% and 73.9%, respectively.
SPS colectomy can be applied to the treatment of colon cancer with good long-term oncological outcomes. However, we should pay more attention when we treat the pathologically diagnosed T4 tumours.
我们回顾性分析了自开展单孔腹腔镜手术（SPS）治疗结肠癌以来的连续病例，并评估了其5年肿瘤学结局。
共有288例患者（140例男性）接受了单孔腹腔镜结肠癌切除术，平均年龄71.5岁，包括I期、II期和III期结肠癌患者。SPS的排除标准为肠梗阻未缓解、T4b肿瘤、肿瘤穿孔及严重内科疾病患者。
20例患者（6.9%）额外增加了一个端口，主要用于横断直肠。中位随访期为52个月。I期、II期和III期患者的5年无复发生存率分别为95.8%、80.2%和61.6%。I期、II期和III期患者的5年总生存率分别为97.4%、85.3%和72.9%。病理诊断为T1、T2、T3和T4的患者5年肿瘤特异性生存率分别为100%、100%、92.1%和73.9%。
SPS结肠切除术可应用于结肠癌治疗，长期肿瘤学结局良好。然而，在治疗病理诊断为T4的肿瘤时应更加谨慎。
