Tsuruta Masashi, Hasegawa Hirotoshi, Okabayashi Koji, Shigeta Kohei, Ishida Takashi, Yahagi Masashi, Ishii Yoshiyuki, Kitagawa Yuko
Department of Surgery, Keio University School of Medicine.
Department of Surgery, Kitasato University Kitasato Institute Hospital.
J Anus Rectum Colon. 2018 May 25;1(2):45-49. doi: 10.23922/jarc.2016-007. eCollection 2017.
This study set out to determine whether Needlescopic surgery (NS) produces comparable surgical outcomes for patients with colorectal cancer (CRC) compared to conventional multi-port laparoscopic surgery (MPS).
We used the five-port method with a 3.5 cm umbilical incision for extraction and reconstruction during MPS for CRC. One or two 5 mm ports were exchanged for needle forceps and all surgical procedures were as for previous MPS since July 2012. We investigated the short-term outcomes of 138 consecutive patients who underwent curative resection of CRC by NS (July 2012-August 2014) and 130 consecutive patients with CRC treated with MPS during a previous period (January 2010-June 2012).
Operative time in the NS group was comparable to that of MPS (p=0.467); the NS group had significantly less estimated blood loss (p=0.002) and a shorter postoperative hospital stay (p<0.001). The mean number of dissected lymph nodes was 27 in both groups (p=0.730). No mortality occurred in either group, and similar morbidity rates were observed (p=0.454).
NS using Endo Relief needle forceps is a safe and feasible option compared to conventional MPS for CRC.
本研究旨在确定与传统多孔腹腔镜手术（MPS）相比，针式腹腔镜手术（NS）对结直肠癌（CRC）患者是否能产生相当的手术效果。
在MPS治疗CRC期间，我们采用五孔法，经3.5 cm脐部切口进行切除和重建。自2012年7月起，将1个或2个5 mm端口换为针式钳，所有手术操作与之前的MPS相同。我们调查了138例连续接受NS根治性切除CRC的患者（2012年7月至2014年8月）和130例之前接受MPS治疗的CRC连续患者（2010年1月至2012年6月）的短期结局。
NS组的手术时间与MPS组相当（p = 0.467）；NS组的估计失血量显著更少（p = 0.002），术后住院时间更短（p < 0.001）。两组的平均清扫淋巴结数均为27个（p = 0.730）。两组均未发生死亡，且观察到相似的发病率（p = 0.454）。
与传统MPS相比，使用Endo Relief针式钳的NS对CRC是一种安全可行的选择。
