Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, Japan.
Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Surg Endosc. 2021 Mar;35(3):1039-1045. doi: 10.1007/s00464-020-07465-z. Epub 2020 Feb 26.
Laparoscopic surgery is a minimally invasive and frequently performed surgical procedure that has become the standard surgery for colorectal cancer. Needlescopic surgery (NS) for colon cancer has also been performed and reported as a less invasive technique. In this study, we investigated the long-term outcomes of NS in comparison with those of conventional surgery (CS).
The data of 1122 patients without distant metastasis who underwent laparoscopic surgery between 2011 and 2014 were retrospectively analyzed. In this study, NS was defined as a laparoscopic procedure performed with the use of 3-mm ports and forceps with one 5-mm port for an energy device, as well as with clips. One 12-mm port was placed in the umbilicus for specimen extraction from the abdominal cavity.
A total of 241 patients underwent NS. There was no significant difference between the 5-year recurrence rate and the 5-year total mortality rate (NS: 10.0% and 5.4% vs. CS: 10.3% and 3.5%, p = 0.86/0.23). In the multivariate analysis, NS was not found to be an independent prognostic factor. In terms of the distribution of recurrence sites, there was no significant difference between the two groups.
NS for colon cancer was not inferior to CS in terms of short-term and long-term outcomes.
腹腔镜手术是一种微创且常施行的手术，已成为结直肠癌的标准手术。针对结肠癌的针式腹腔镜手术（NS）也已施行并报道为一种微创技术。本研究旨在比较 NS 与传统手术（CS）的长期疗效。
回顾性分析了 2011 年至 2014 年间接受腹腔镜手术且无远处转移的 1122 例患者的数据。本研究中，NS 定义为使用 3mm 端口和抓钳、1 个 5mm 端口用于能量器械以及夹闭器进行的腹腔镜手术，另在脐部置入 1 个 12mm 端口以从腹腔取出标本。
共有 241 例患者接受 NS。5 年复发率和 5 年总死亡率在 NS 组和 CS 组之间无显著差异（NS：10.0%和 5.4% vs. CS：10.3%和 3.5%，p=0.86/0.23）。多因素分析显示，NS 不是独立的预后因素。在复发部位的分布方面，两组之间无显著差异。
NS 治疗结肠癌在短期和长期疗效方面不劣于 CS。
