Enciu Octavian, Avino Adelaida, Calu Valentin, Toma Elena Adelina, Tulin Adrian, Tulin Raluca, Slavu Iulian, Răducu Laura, Balcangiu-Stroescu Andra-Elena, Gheoca Mutu Daniela-Elena, Tomescu Luminiţa Florentina, Miron Adrian
Discipline of General Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 020021, Romania.
Department of General Surgery, Elias University Emergency Hospital, Bucharest 11468, Romania.
Exp Ther Med. 2022 May 20;24(1):455. doi: 10.3892/etm.2022.11382. eCollection 2022 Jul.
Despite concerns regarding oncologic safety, laparoscopic surgery for colon cancer has been proven in several trials in the lasts decades to be superior to open surgery. In addition, the benefits of laparoscopic surgery can be offered to other patients with malignant disease. The aim of the present study was to compare the quality of oncologic resection for non-metastatic, resectable colon cancer between laparoscopic and open surgery in terms of specimen margins and retrieved lymph nodes in a medium volume center in Romania. A total of 219 patients underwent surgery for non-metastatic colon cancer between January 2017 and December 2020. Of these, 52 underwent laparoscopic resection, while 167 had open surgery. None of the patients in the laparoscopic group had positive circumferential margins (P=0.035) while 12 (7.19%) patients in the open group (OG) had positive margins. A total of three patients in the laparoscopic group (5.77%) and seven patients (4.19%) in the OG had invaded axial margins. While the number of retrieved lymph nodes was not correlated with the type of procedure [laparoscopic group 16.12 (14±6.56), OG 17.31 (15±8.42), P=0.448], the lymph node ratio was significantly higher in the OG (P=0.003). Given the results of the present study, it is safe to conclude that laparoscopic surgery is not inferior to open surgery for non-metastatic colon cancer in a medium volume center.
尽管存在对肿瘤学安全性的担忧，但在过去几十年的多项试验中已证明，结肠癌的腹腔镜手术优于开放手术。此外，腹腔镜手术的益处也可惠及其他恶性疾病患者。本研究的目的是在罗马尼亚的一个中等规模中心，就标本切缘和获取的淋巴结情况，比较腹腔镜手术与开放手术治疗非转移性、可切除结肠癌的肿瘤切除质量。2017年1月至2020年12月期间，共有219例患者接受了非转移性结肠癌手术。其中，52例行腹腔镜切除术，167例行开放手术。腹腔镜组患者均无环周切缘阳性（P=0.035），而开放组有12例（7.19%）患者切缘阳性。腹腔镜组共有3例患者（5.77%）和开放组7例患者（4.19%）有轴向切缘受侵。虽然获取的淋巴结数量与手术方式无关[腹腔镜组16.12（14±6.56），开放组17.31（15±8.42），P=0.448]，但开放组的淋巴结比率显著更高（P=0.003）。根据本研究结果，可以有把握地得出结论，在中等规模中心，腹腔镜手术治疗非转移性结肠癌并不逊色于开放手术。
