Department of Surgery, Yokohama City University, Yokohama, Japan.
Department of Surgery, Yokohama Minami Kyosai Hospital, Yokohama, Japan.
J Cancer Res Ther. 2022 Jul-Sep;18(4):898-902. doi: 10.4103/jcrt.JCRT_946_20.
Previous randomized controlled trials demonstrated similar oncological outcomes between laparoscopic-assisted (LA) and open (OP) colectomy; however, patients with transverse colon cancer were not analyzed. The aim of this study was to confirm the oncological safety and the advantages of the short- and long-term results of LA surgery for transverse colon cancer in comparison to OP surgery.
The study data were retrospectively collected from the databases of four hospitals. Patients with transverse colon cancer who underwent LA or OP R0 or R1 resection were registered.
Among the 204 patients, 149 underwent OP colectomy and 55 underwent LA colectomy. The median follow-up period was 43 months. The rate of conversion to OP resection was 7.3%. The 5-year overall survival rate of the LA group was higher than that of the OP surgery group for all-stage patients (97.5% vs. 91.1%, P = 0.108), and it was similar in Stage II and Stage III patients (94.1% vs. 94.2%, P = 0.510). The LA group had significantly lower blood loss and a significantly longer operative time in comparison to the OP surgery group. Furthermore, the postoperative hospital stay was significantly shorter (9 vs. 13 days, P = 0.001) and the incidence of Grade ≥III complications was lower in the LA group (3.7% vs. 14.8%, P = 0.031).
We concluded that LA surgery for transverse colon cancer is oncologically safe and yields better short-term results in comparison to OP surgery.
先前的随机对照试验表明，腹腔镜辅助（LA）和开放（OP）结直肠切除术的肿瘤学结果相似；然而，未对横结肠癌患者进行分析。本研究旨在确认 LA 手术治疗横结肠癌的肿瘤学安全性和短期及长期结果优势，并与 OP 手术进行比较。
本研究的数据是从四家医院的数据库中回顾性收集的。登记了接受 LA 或 OP R0 或 R1 切除术的横结肠癌患者。
在 204 例患者中，149 例行 OP 结肠切除术，55 例行 LA 结肠切除术。中位随访时间为 43 个月。中转 OP 切除术的比率为 7.3%。LA 组的 5 年总生存率高于 OP 手术组的所有分期患者（97.5% vs. 91.1%，P = 0.108），且 II 期和 III 期患者相似（94.1% vs. 94.2%，P = 0.510）。与 OP 手术组相比，LA 组的出血量更少，手术时间更长。此外，LA 组的术后住院时间明显更短（9 天 vs. 13 天，P = 0.001），且 III 级及以上并发症的发生率更低（3.7% vs. 14.8%，P = 0.031）。
我们得出结论，LA 手术治疗横结肠癌在肿瘤学上是安全的，与 OP 手术相比，短期结果更好。
