Taesombat Wipusit, Kanjanasilp Prapon, Nonthasoot Bunthoon, Sutherasan Methee, Vorasittha Athaya, Sirichindakul Boonchoo
Department of Surgery, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
Ann Med Surg (Lond). 2020 Sep 6;58:120-123. doi: 10.1016/j.amsu.2020.09.009. eCollection 2020 Oct.
Laparoscopic surgery for colorectal cancer and liver tumors are accepted as alternative procedure to open surgery. However, few studies reported outcomes of simultaneous laparoscopic surgery of these two procedures. The aim of this study was to compare short-term outcomes between laparoscopic and open approach.
Between June 2010 to December 2019, simultaneous laparoscopic cases were retrospectively matched (1:2) to open cases. Peri-operative and short-term outcomes were compared between both groups.
Twelve patients in laparoscopic group were matched to 24 patients in open group according to age, gender, body mass index, american society of anesthesiologists physical status, preoperative laboratory data, number and size of liver metastases and extent of colorectal and liver resection, Most patients in each group had left-sided colon or rectal cancer and underwent wedge liver resection. The mean number of liver metastases was 1.3 vs 1.5 and size of liver metastases was 2.2 ± 1.4 vs 2.7 ± 1.1 cm in laparoscopic compared to open group. Estimated blood loss and length of hospital stay were significantly lower in laparoscopic group. However, operative time was significantly longer in laparoscopic group. Peri-operative complication was not significant difference between both groups and there was no mortality.
Simultaneous laparoscopic colorectal surgery and minor liver resection is feasible and safe. Laparoscopic approach has better peri-operative outcome in term of shorter length of hospital stay compared to open approach.
腹腔镜手术治疗结直肠癌和肝肿瘤已被公认为开腹手术的替代方法。然而,很少有研究报道这两种手术同时进行腹腔镜手术的结果。本研究的目的是比较腹腔镜手术和开腹手术的短期结果。
2010年6月至2019年12月,对同期腹腔镜手术病例与开腹手术病例进行回顾性1:2匹配。比较两组的围手术期和短期结果。
根据年龄、性别、体重指数、美国麻醉医师协会身体状况、术前实验室数据、肝转移灶的数量和大小以及结直肠和肝脏切除范围,腹腔镜组12例患者与开腹组24例患者相匹配。每组大多数患者患有左半结肠癌或直肠癌,并接受了肝楔形切除术。与开腹组相比,腹腔镜组肝转移灶的平均数量分别为1.3个和1.5个,肝转移灶大小分别为(2.2±1.4)cm和(2.7±1.1)cm。腹腔镜组的估计失血量和住院时间显著更低。然而,腹腔镜组的手术时间显著更长。两组围手术期并发症无显著差异,且无死亡病例。
同期腹腔镜结直肠手术和小范围肝切除术是可行且安全的。与开腹手术相比,腹腔镜手术在缩短住院时间方面具有更好的围手术期结果。