Cho Jin-Kyu, Kim Jae-Ri, Jang Jae-Yool, Kim Han-Gil, Kim Jae-Myung, Kwag Seung-Jin, Park Ji-Ho, Kim Ju-Yeon, Ju Young-Tae, Jeong Chi-Young
Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79, Gangnam-ro, Jinju 52727, Korea.
Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Changwon-si 51472, Korea.
J Clin Med. 2022 May 8;11(9):2644. doi: 10.3390/jcm11092644.
Although laparoscopic treatment for T1 gallbladder cancer (GBC) has been described previously, the differences in oncologic outcomes between laparoscopic and conventional open surgery for T2 GBC have not been investigated. We aimed to assess the role of laparoscopic surgery using retrospectively collected data for 81 patients with T2 GBC who underwent surgical resection between January 2010 and December 2017. Eligible patients were classified into "laparoscopic" and "open" groups. Propensity-score matching was performed in a 1:1 ratio. The effects of surgery type on surgical and oncological outcomes were investigated. After propensity-score matching, 19 patients were included in the open and laparoscopic surgery groups. The median follow-up durations were 70 and 26 months in the open and laparoscopic groups, respectively. The operative time (316.8 ± 80.3 vs. 218.9 ± 145.0 min, = 0.016) and length of postoperative hospital stay (14.4 ± 6.0 vs. 8.4 ± 5.9 days, = 0.004) were significantly shorter in the laparoscopic group. The three-year overall (86.3% vs. 88.9%, = 0.660) and disease-free (76.4% vs. 60.2%, = 0.448) survival rates were similar between the groups. Propensity-score matching showed that laparoscopic surgery for T2 GBC yielded similar long-term oncological outcomes and favorable short-term outcomes in comparison with open surgery. Laparoscopic treatment should be considered in patients with T2 GBC.
尽管此前已有关于腹腔镜治疗T1期胆囊癌（GBC）的描述，但腹腔镜手术与传统开放手术治疗T2期GBC的肿瘤学结局差异尚未得到研究。我们旨在通过回顾性收集2010年1月至2017年12月期间接受手术切除的81例T2期GBC患者的数据，评估腹腔镜手术的作用。符合条件的患者被分为“腹腔镜”组和“开放”组。以1:1的比例进行倾向评分匹配。研究手术类型对手术和肿瘤学结局的影响。倾向评分匹配后，开放手术组和腹腔镜手术组各纳入19例患者。开放组和腹腔镜组的中位随访时间分别为70个月和26个月。腹腔镜组的手术时间（316.8±80.3 vs. 218.9±145.0分钟，P = 0.016）和术后住院时间（14.4±6.0 vs. 8.4±5.9天，P = 0.004）明显更短。两组的三年总生存率（86.3% vs. 88.9%，P = 0.660）和无病生存率（76.4% vs. 60.2%，P = 0.448）相似。倾向评分匹配显示，与开放手术相比，T2期GBC的腹腔镜手术产生了相似的长期肿瘤学结局和良好的短期结局。对于T2期GBC患者，应考虑腹腔镜治疗。
