Naeem Awais, Shakeel Osama, Ashraf Ijaz, Riaz Sheryar, Haq Ihtisham, Shah Muhammad F, Anwer Abdul Wahid, Nasir Irfan Ul Islam, Amjad Awais, Khattak Shahid, Syed Aamir Ali
Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
Cureus. 2020 Jul 29;12(7):e9465. doi: 10.7759/cureus.9465.
Introduction Laparoscopic colonic resection is increasingly becoming popular worldwide and aims to provide curative resection in addition to the inherent benefits of laparoscopic surgery. The aim of this study was to evaluate the long-term outcomes of laparoscopic right hemicolectomy in a Pakistani cohort of patients. Methods and procedures We retrospectively analyzed the medical records of all patients who presented to our hospital with the diagnosis of right-sided colon carcinoma from January 2010 to December 2018 and underwent laparoscopic right or extended right hemicolectomy. Demographics, operative findings, histopathology report, and follow-up of patients were recorded and the analysis was performed on Statistical Packages for the Social Sciences (SPSS) Version 20 (IBM Corp, Armonk, NY). Results Seventy-five patients were included, 56 (74.7%) of whom were males and 19 (25.3%) were females. The median age was 52 years (range 25-82 years). The median hospital stay was five days (Range 3-13 days). The median blood loss was 70 milliliters and the mean operative time was 195.5±77.6 minutes. Laparoscopic extended right hemicolectomy was performed in 23 (16.67%) patients and standard right hemicolectomy in 52 (83.33%) patients. Most (72%) of the patients had a pathological T3 tumor, and the majority (61.3%) of the patients had no nodal involvement (pN0). The mean number of lymph nodes removed was 20+8. The median numbers of involved lymph nodes were 1.14+2.19. All the patients had R0 resection. Postoperatively, two patients had pelvic collection, and there was no 30-day mortality. Local recurrence occurred in four patients and distant metastases were observed in nine patients. The median follow-up in our study was 40.5±18.35 months. The median disease-free survival was 42±2.17 months and the median overall survival was 44±2.16 months. Conclusion Our experience with laparoscopic right colon resections has confirmed the safety and feasibility of the procedure.
引言
腹腔镜结肠切除术在全球范围内越来越受欢迎,其目的是在提供腹腔镜手术固有优势的同时进行根治性切除。本研究的目的是评估巴基斯坦一组患者行腹腔镜右半结肠切除术的长期疗效。
方法与步骤
我们回顾性分析了2010年1月至2018年12月期间因右侧结肠癌诊断入我院并接受腹腔镜右半结肠切除术或扩大右半结肠切除术的所有患者的病历。记录患者的人口统计学资料、手术发现、组织病理学报告及随访情况,并使用社会科学统计软件包(SPSS)20版(IBM公司,纽约州阿蒙克)进行分析。
结果
共纳入75例患者,其中男性56例(74.7%),女性19例(25.3%)。中位年龄为52岁(范围25 - 82岁)。中位住院时间为5天(范围3 - 13天)。中位失血量为70毫升,平均手术时间为195.5±77.6分钟。23例(16.67%)患者行腹腔镜扩大右半结肠切除术,52例(83.33%)患者行标准右半结肠切除术。大多数(72%)患者患有病理T3期肿瘤,大多数(61.3%)患者无淋巴结转移(pN0)。平均切除淋巴结数为20 + 8个。受累淋巴结的中位数为1.14 + 2.19个。所有患者均行R0切除。术后,2例患者出现盆腔积液,无30天死亡率。4例患者发生局部复发,9例患者出现远处转移。本研究的中位随访时间为40.5±18.35个月。无病生存期的中位数为42±2.17个月,总生存期的中位数为44±2.16个月。
结论
我们行腹腔镜右半结肠切除术的经验证实了该手术的安全性和可行性。