Department of General Surgery, University of Medicine and Pharmacy at Ho Chi Minh City, 70000, Vietnam.
Department of Gastrointestinal Surgery, University Medical Center Ho Chi Minh City, 70000, Vietnam.
Biomed Res Int. 2020 Nov 11;2020:1762151. doi: 10.1155/2020/1762151. eCollection 2020.
The choice of optimal treatment strategies for T4b colon cancers has still been discussed, particularly the initiation of neoadjuvant therapy or surgery. We conducted this study to evaluate the safety and feasibility of laparoscopic multivisceral resection for T4b colon cancers.
We used the retrospective design to include all 43 patients with T4b colon cancer at a university hospital in Vietnam from March 2017 to March 2019. All patients were followed 30 days after the surgery, and information about the day of the first flatus, length of hospital stay, iatrogenic complications, postoperative morbidity, mortality, and adjuvant chemotherapy was collected.
The mean operating time was 187 minutes (ranging from 80 to 310), the mean blood loss was 64.3 ml (5-200), and the conversion rate was 2.3%. The mean number of lymph nodes harvested was 15.5 (SD = 8.06), and 33 patients (76.7%) had at least 12 lymph nodes harvested. A total of 21 patients (48.8%) had lymph node metastases with a mean number of lymph node metastases of 1.89 (SD = 3.4). The radial resection margin was R0 in all 43 patients (100%). The median time until the first flatus and hospital stay were 3 days (2-5) and 7.1 (6-11) days, respectively. There was no mortality at 30 days postoperatively, and one patient had iatrogenic complication (2.3%).
Laparoscopic radical colectomy was feasible and safe for patients with T4b colon cancer except those requiring major and complicated reconstruction.
对于 T4b 结肠癌，选择最佳的治疗策略仍在讨论中，尤其是新辅助治疗或手术的启动。我们进行这项研究是为了评估腹腔镜多脏器切除术治疗 T4b 结肠癌的安全性和可行性。
我们采用回顾性设计，纳入了 2017 年 3 月至 2019 年 3 月期间在越南一家大学医院就诊的所有 43 例 T4b 结肠癌患者。所有患者均在手术后 30 天内进行随访，并收集了首次排气日、住院时间、医源性并发症、术后发病率、死亡率和辅助化疗等信息。
手术的平均操作时间为 187 分钟（80-310 分钟），平均失血量为 64.3ml（5-200ml），中转开腹率为 2.3%。平均淋巴结清扫数目为 15.5 个（标准差=8.06），33 例（76.7%）患者至少清扫了 12 个淋巴结。21 例（48.8%）患者发生淋巴结转移，平均转移淋巴结数目为 1.89 个（标准差=3.4）。所有 43 例患者的切缘均为 R0（100%）。首次排气和住院时间中位数分别为 3 天（2-5 天）和 7.1 天（6-11 天）。术后 30 天内无死亡病例，1 例患者发生医源性并发症（2.3%）。
除需要进行大手术和复杂重建的患者外，腹腔镜根治性结肠切除术治疗 T4b 结肠癌是可行且安全的。
