开放性与腹腔镜辅助结直肠切除术治疗结直肠梗阻的对比。
A Comparison of Open and Laparoscopic-assisted Colectomy for Obstructive Colon Cancer.
机构信息
Department of Surgery, Yokohama City University, Yokohama, Japan
Department of Surgery, Yokohama City University, Yokohama, Japan.
出版信息
In Vivo. 2020 Sep-Oct;34(5):2797-2801. doi: 10.21873/invivo.12105.
BACKGROUND/AIM: We performed a retrospective multi-center cohort analysis to compare the outcomes of laparoscopic surgery vs. open surgery for obstructive colon cancer.
PATIENTS AND METHODS
A total of 455 patients with colon cancer with ileus underwent surgery at Yokohama City University Hospital and four related institutions from April 2000 to March 2016.
RESULTS
There were 414 cases in the open surgery group and 41 cases in the laparoscopic surgery group with no marked differences in the gender or age. The postoperative complication rate, according to the Clavien-Dindo classification, was lower in the laparoscopic group compared to the open surgery group. The postoperative hospital stay was 16 days in the open surgery group and 9 days in the laparoscopic surgery group (p=0.004). Among the various factors examined, the operation approach was identified as a statistically significant independent risk factor for postoperative complications (p=0.015).
CONCLUSION
Preoperative treatment for colon cancer with ileus and elective laparoscopic surgery are thought to be useful for achieving curative treatment, avoiding colostomy, and shortening the length of hospital stay.
背景/目的：我们进行了一项回顾性多中心队列分析，比较了腹腔镜手术与开放手术治疗梗阻性结肠癌的疗效。
患者与方法
2000 年 4 月至 2016 年 3 月，横滨市立大学医院及四家相关机构对 455 例因结肠癌并发肠梗阻而接受手术的患者进行了研究。
结果
开放手术组 414 例，腹腔镜手术组 41 例，两组患者在性别和年龄方面无明显差异。腹腔镜组术后并发症发生率（根据 Clavien-Dindo 分级）低于开放手术组。开放手术组的术后住院时间为 16 天，腹腔镜手术组为 9 天（p=0.004）。在检查的各种因素中，手术方式被确定为术后并发症的统计学显著独立危险因素（p=0.015）。
结论
对于并发肠梗阻的结肠癌的术前治疗和选择性腹腔镜手术被认为有助于实现根治性治疗、避免肠造口术以及缩短住院时间。
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