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直肠癌单孔与多孔手术的系统评价

Systematic review of single-port vs. multi-port surgery for rectal cancer.

作者信息

Tei Mitsuyoshi, Sueda Toshinori, Matsumura Tae, Furukawa Haruna, Koga Chikato, Wakasugi Masaki, Miyagaki Hiromichi, Kawabata Ryohei, Tsujie Masanori, Hasegawa Junichi

机构信息

Department of Surgery, Osaka Rosai Hospital, Kita-ku, Sakai, Osaka 591-8025, Japan.

出版信息

Mol Clin Oncol. 2021 Feb;14(2):24. doi: 10.3892/mco.2020.2186. Epub 2020 Dec 4.

Abstract

The aim of the current systematic review was to compare the short-term clinical and oncological outcomes of single-port surgery (SPS) to multi-port surgery (MPS) for rectal cancer in MEDLINE, PubMed and Cochrane Library from January 2010 to December 2018. A total of 5 clinical controlled studies composed one randomized pilot study and four non-randomized studies with a total of 461 patients were analyzed after a systematic review. A total of 125 patients (27.1%) underwent SPS and 336 patients (72.9%) underwent MPS for rectal cancer. The rate of conversion to open surgery was lower in the SPS group compared with the MPS group (0.8 vs. 5.4%, respectively). A total of 16.8% of patients in the SPS group required an additional port to complete the operation. The morbidity rate was lower in the SPS group compared with the MPS group (28.0 vs. 39.0%, respectively). The other short-term clinical outcomes were similar in both groups. The R0 resection rate was 99.0% in the SPS group and 98.7% in the MPS group. The oncological clearance was satisfactory and similar in both groups. The current study concluded that SPS can be performed safely and provide satisfactory oncological outcomes in patients with rectal cancer. However, further studies are required to determine the role of SPS in the long-term clinical and oncological outcomes.

摘要

本系统评价的目的是,在2010年1月至2018年12月期间,比较单孔手术(SPS)与多孔手术(MPS)治疗直肠癌的短期临床和肿瘤学结局。经系统评价后,分析了5项临床对照研究,其中包括1项随机试验研究和4项非随机研究,共461例患者。共有125例患者(27.1%)接受了直肠癌单孔手术,336例患者(72.9%)接受了多孔手术。与多孔手术组相比,单孔手术组中转开腹手术的比例更低(分别为0.8%和5.4%)。单孔手术组共有16.8%的患者需要增加一个端口来完成手术。与多孔手术组相比,单孔手术组的发病率更低(分别为28.0%和39.0%)。两组的其他短期临床结局相似。单孔手术组的R0切除率为99.0%,多孔手术组为98.7%。两组的肿瘤学切缘均令人满意且相似。本研究得出结论,直肠癌患者行单孔手术可安全进行,并能提供令人满意的肿瘤学结局。然而,需要进一步研究以确定单孔手术在长期临床和肿瘤学结局中的作用。

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