Kim Chang Woo, Yang Seung Yoon, Hur Hyuk
Department of Surgery, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Korea.
Division of Colon and Rectal Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
Surg Endosc. 2022 May;36(5):3200-3208. doi: 10.1007/s00464-021-08629-1. Epub 2021 Aug 31.
Studies find similar perioperative outcomes between single-incision laparoscopic surgery (SILS) and conventional laparoscopic surgery (CLS) for colon cancer. However, few have reported long-term outcomes of SILS versus CLS. We aimed to compare long-term postoperative and oncologic outcomes as well as perioperative outcomes between SILS and CLS for colon cancer.
A total of 641 consecutive patients who underwent laparoscopic surgery for colon cancer from July 2009 to September 2014 were eligible for the study. Data from 300 of these patients were used for analysis after propensity score-matching (n = 150 per group). Variables associated with short- and long-term outcomes were analyzed.
The SILS group had a shorter mean total incision length, less postoperative pain, and a similar mean rate of incisional hernia (2.7% versus 3.3%) compared with the CLS group. The 7-year overall and disease-free survival rates were 92.7% versus 94% (p = 0.673) and 85.3% versus 84.7% (p = 0.688) in the SILS and CLS groups, respectively.
Compared with CLS, SILS for colon cancer appeared to be safe in terms of perioperative and long-term postoperative and oncologic outcomes. The results suggested that SILS is a reasonable treatment option for colon cancer for a selected group of patients.
研究发现，单切口腹腔镜手术（SILS）与传统腹腔镜手术（CLS）治疗结肠癌的围手术期结果相似。然而，很少有研究报告SILS与CLS的长期结果。我们旨在比较SILS与CLS治疗结肠癌的术后长期和肿瘤学结果以及围手术期结果。
共有641例在2009年7月至2014年9月期间接受腹腔镜结肠癌手术的连续患者符合本研究条件。在进行倾向得分匹配后，使用其中300例患者的数据进行分析（每组n = 150）。分析与短期和长期结果相关的变量。
与CLS组相比，SILS组的平均总切口长度更短，术后疼痛更少，切口疝的平均发生率相似（2.7%对3.3%）。SILS组和CLS组的7年总生存率和无病生存率分别为92.7%对94%（p = 0.673）和85.3%对84.7%（p = 0.688）。
与CLS相比，SILS治疗结肠癌在围手术期、术后长期和肿瘤学结果方面似乎是安全的。结果表明，对于选定的一组患者，SILS是结肠癌的一种合理治疗选择。
