Ichihara Momoko, Uemura Mamoru, Ikeda Masataka, Miyake Masakazu, Kato Takeshi, Hamakawa Takuya, Maeda Sakae, Hama Naoki, Nishikawa Kazuhiro, Miyamoto Atsushi, Miyazaki Michihiko, Hirao Motohiro, Sekimoto Mitsugu
Department of Surgery, National Hospital Organization Osaka National Hospital, Chuo-ku, Osaka.
Department of Surgery, Division of Lower Gastrointestinal Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Surg Laparosc Endosc Percutan Tech. 2019 Oct;29(5):389-392. doi: 10.1097/SLE.0000000000000699.
Pelvic exenteration (PE) for locally advanced or recurrent colorectal cancer is often used to secure negative resection margins. The aim of this study was to evaluate the feasibility of laparoscopic PE.
The clinical records of 24 patients (9, open; 15, laparoscopic) who underwent total or posterior PE for locally advanced or recurrent colorectal cancer between July 2012 and April 2016 at Osaka National Hospital were retrospectively reviewed. Operative factors were compared between the 2 groups.
The R0 resection rate was 100% in the laparoscopic group and 89% in the open group. The operative time and the incidence of postoperative complications were not significantly different between the 2 groups. The laparoscopic group showed less intraoperative blood loss (P=0.019), a lower C-reactive protein elevation on postoperative day 7 (P=0.025), and a shorter postoperative hospital stay (P=0.0009).
Laparoscopic PE is a safe and feasible procedure to reduce postoperative stress.
盆腔脏器切除术（PE）常用于局部进展期或复发性结直肠癌以确保切缘阴性。本研究旨在评估腹腔镜PE的可行性。
回顾性分析2012年7月至2016年4月在大阪国立医院接受全盆腔或后盆腔脏器切除术治疗局部进展期或复发性结直肠癌的24例患者（9例开放手术；15例腹腔镜手术）的临床记录。比较两组的手术相关因素。
腹腔镜组R0切除率为100%，开放组为89%。两组手术时间和术后并发症发生率无显著差异。腹腔镜组术中出血量较少（P=0.019），术后第7天C反应蛋白升高幅度较低（P=0.025），术后住院时间较短（P=0.0009）。
腹腔镜PE是一种安全可行的手术方式，可减轻术后应激反应。
