Abdominal Surgery Department, Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú.
Propsective and Data Intelligence Unit, Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú.
Rev Gastroenterol Peru. 2022 Jan-Mar;42(1):33-40.
The study aimed to describe and compare minimally invasive surgery (MIS) and open surgery for rectal cancer in Peru.
A retrospective single-center analysis was performed for all patients who underwent sphinctersparing surgery for non-metastatic rectal cancer at Instituto Nacional de Enfermedades Neoplásicas in Peru between January 2016 and December 2020. Clinical, perioperative, pathological, and survival outcomes were compared between both groups. A propensity score matching method was used to minimize bias.
162 patients were included in the final analysis. 124 had open surgery and 38 had MIS. Patients, clinical tumour, pathological characteristics, and perioperative were similar between groups after matching. Similar circumferential resection margin (CRM) with optimal quality of the mesorectum (p=1.000) but higher number of lymph nodes resected in open surgery group (p=0.741) was described. The leakage rate was slightly higher in the MIS group (p=0.358) with 10.5%, while the postoperative hospital stay was longer in the open surgery group after matching (p=0.001; OR 95% 5.2 CI: 1.8-15.6). The estimated recurrence-free survival (RFS) and overall survival (OS) at 3 years in open surgery and MIS was 71.8% (95% CI; 0.58-0.89) and 70% (95% CI; 0.56-0.88) (p=0.431) and 77.7% (95% CI; 0.64-0.94) and 88.9% (95% CI; 0.79-0.99) (p=0.5), respectively.
Shorter postoperative hospital stay in the minimally invasive surgery group was reported. RFS, OS, and recurrence rates were similar between both groups. This approach is for non-metastatic rectal cancer in referral centers in Peru.
本研究旨在描述和比较秘鲁的微创外科（MIS）和开放手术治疗直肠癌。
对 2016 年 1 月至 2020 年 12 月期间在秘鲁国家肿瘤研究所接受非转移性直肠癌保肛手术的所有患者进行回顾性单中心分析。比较两组之间的临床、围手术期、病理和生存结果。采用倾向评分匹配法以最小化偏倚。
最终分析纳入 162 例患者。其中 124 例接受开放手术，38 例接受 MIS。匹配后两组患者、临床肿瘤、病理特征和围手术期均相似。MIS 组的环周切缘（CRM）相似且直肠系膜质量较高（p=1.000），但开放手术组的淋巴结清扫数量更多（p=0.741）。MIS 组的漏诊率略高（p=0.358）为 10.5%，但匹配后开放手术组的术后住院时间更长（p=0.001；OR 95%CI：1.8-15.6）。开放手术和 MIS 组的 3 年无复发生存率（RFS）和总生存率（OS）分别为 71.8%（95%CI：0.58-0.89）和 70%（95%CI：0.56-0.88）（p=0.431）和 77.7%（95%CI：0.64-0.94）和 88.9%（95%CI：0.79-0.99）（p=0.5）。
报告了微创外科组术后住院时间更短。两组的 RFS、OS 和复发率相似。这种方法适用于秘鲁转诊中心的非转移性直肠癌。
