Department of Surgical Oncology, South Egypt Cancer Institute, Assiut University, Asyut, Egypt.
Department of Surgical Oncology, Tanta Cancer Center, Tanta, Egypt.
Int J Surg Oncol. 2021 Feb 2;2021:8859879. doi: 10.1155/2021/8859879. eCollection 2021.
The mean operative time was significantly longer in the LCME group than that in the OCME group with less mean intraoperative blood loss. Conversion was required in 4 patients (8.3%) in the LCME group. The use of laparoscopy increased the number of harvested lymph nodes compared to the open approach (39.81 ± 16.74 vs. 32.65 ± 12.28, respectively, =0.010). The laparoscopic approach was associated with a shorter time interval to first flatus as well as shorter time interval to liquid and normal diet after surgery. The postoperative hospital stay was significantly shorter in the LCME group. The complication rate was slightly lower in the LCME (14.7%) than in the OCME group (27.2%) (=0.252). The 3-year OS in the LCME group was similar to that in OCME (78.2% vs. 63.2%, respectively, value = 0.423). The three-year DFS in the laparoscopic group was higher (74.5%) than the open group (60.0%), but did not reach statistical significance ( value = 0.266).
In conclusion, laparoscopic CME right hemicolectomy is a technically feasible and safe procedure if surgeon expertise is present. LCME has long-term oncologic outcomes (recurrence and survival) comparable to open surgery for management of patients with stage II or III colon cancer.
LCME 组的平均手术时间明显长于 OCME 组，术中平均失血量较少。LCME 组中有 4 例（8.3%）需要中转开腹。与开腹相比，腹腔镜增加了淋巴结的清扫数量（分别为 39.81±16.74 个和 32.65±12.28 个，=0.010）。腹腔镜手术与术后首次排气时间间隔以及术后开始流质和正常饮食的时间间隔更短。LCME 组的术后住院时间明显缩短。LCME 组的并发症发生率（14.7%）略低于 OCME 组（27.2%）（=0.252）。LCME 组的 3 年 OS 与 OCME 组相似（分别为 78.2%和 63.2%，值=0.423）。腹腔镜组的 3 年 DFS 更高（74.5%），高于开腹组（60.0%），但未达到统计学意义（值=0.266）。
总之，如果外科医生具备专业技能，腹腔镜 CME 右半结肠切除术是一种可行且安全的技术。LCME 对 II 期或 III 期结肠癌患者的管理具有长期的肿瘤学结果（复发和生存），与开腹手术相当。
