Tan Henry Chor Lip, Tan Jih Huei, Nur Dzainuddin Nur Akmalrudin, Chan Koon Khee
Colorectal Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia.
Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Ann Coloproctol. 2020 Apr;36(2):94-101. doi: 10.3393/ac.2019.05.10. Epub 2020 Mar 16.
The purpose of this study was to demonstrate the feasibility and safety of laparoscopic-assisted anterior resection (LAAR) for colorectal cancer in a local Asian population.
This is a retrospective review of all patients with colorectal cancer operated from November 2017 to October 2018. Main variables of interest were demography, type and surgery, length of stay (LOS), and the involvement of proximal and distal doughnut. Postoperative complications were analysed using chi-square or Fisher exact and Mann-Whitney tests.
There were 23 patients with a mean age of 62.5 ± 12.2 years. The mean time from diagnosis to surgery was 97.1 ± 154.84 days. There were 12 patients in the LAAR group and 11 in the open anterior resection (OAR) group. Duration of surgery was shorter in OAR (129.58 ± 51.38 minutes) compared to LAAR (147.91 ± 39.37 minutes). Mean LOS was shorter in the LAAR group with 5±1.5 days compared to the OAR group of 7.42 ± 4.25 days. However, there was no significant P-value for both duration of surgery (P = 0.322) or LOS (P = 0.87). A total of 3 complications were recorded after OAR and 2 after LAAR. Both groups had clear proximal and distal margins with 16 (12-18.5) harvested lymph nodes in LAAR and 18 (16-22) in OAR, which were equal (P = 0.155).
This study reports a shorter LOS in the minimally invasive group of 2 days with similar oncologic resection outcomes. This shows that LAAR is feasible in Malaysia and has potential outcome benefits.
本研究旨在证明在亚洲当地人群中，腹腔镜辅助前切除术（LAAR）治疗结直肠癌的可行性和安全性。
这是一项对2017年11月至2018年10月期间所有接受结直肠癌手术患者的回顾性研究。主要关注变量包括人口统计学、手术类型、住院时间（LOS）以及近端和远端切缘情况。使用卡方检验、Fisher精确检验和曼-惠特尼检验分析术后并发症。
共有23例患者，平均年龄为62.5±12.2岁。从诊断到手术的平均时间为97.1±154.84天。LAAR组有12例患者，开放前切除术（OAR）组有11例患者。与LAAR（147.91±39.37分钟）相比，OAR的手术时间更短（129.58±51.38分钟）。LAAR组的平均住院时间为5±1.5天，短于OAR组的7.42±4.25天。然而，手术时间（P = 0.322）和住院时间（P = 0.87）的P值均无统计学意义。OAR术后共记录3例并发症，LAAR术后记录2例并发症。两组的近端和远端切缘均清晰，LAAR组采集的淋巴结数量为16（12 - 18.5）枚，OAR组为18（16 - 22）枚，两组数量相当（P = 0.155）。
本研究报告微创组的住院时间缩短了2天，肿瘤切除效果相似。这表明LAAR在马来西亚是可行的，且具有潜在的良好预后效益。
