同一天由同一位外科医生施行两种腹腔镜结肠癌手术的可行性。
Feasibility of two laparoscopic surgeries for colon cancer performed by the same surgeon on a single day.
机构信息
Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.
Clinical Research Center, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.
出版信息
Int J Colorectal Dis. 2023 Feb 3;38(1):27. doi: 10.1007/s00384-023-04325-9.
BACKGROUND
Although the proportion of laparoscopic colectomies (LCs) for colon cancer is increasing, the feasibility of the same surgeon performing two LCs on a single day remains unknown. This study was conducted to clarify the feasibility of this practice by evaluating short-term and long-term outcomes.
METHODS
This retrospective analysis enrolled patients with pathological stage I-III colon cancer who underwent LC at the Shizuoka Cancer Center between 2010 and 2020. Patients were divided into two groups based on the timing of the surgery for the surgeon. The first group (n = 1485) comprised patients who underwent LC as the first surgery of the day for the surgeon. The second group (n = 163) comprised patients who underwent LC as the second LC of the day for the surgeon. Propensity score matching was performed to balance the baseline characteristics of the first and second groups. The short-term and long-term outcomes of the two groups were compared.
RESULTS
After propensity score matching, there were no significant differences in the incidence of postoperative complications of Clavien-Dindo classification grade II or higher between the first (10.4%, 17/163) and second groups (5.5%, 9/163). There were no significant differences in other perioperative outcomes, including operative time, intraoperative blood loss, and incidence of conversion to open surgery, between the two groups. Regarding long-term outcomes, there were no significant differences in overall survival or relapse-free survival between the two groups both in the full cohort and in the propensity score-matched cohort. In the propensity score-matched cohort, 5-year overall survival was 92.7% in the first group and 94.4% in the second group; 5-year relapse-free survival was 87.1% and 90.3%, respectively.
CONCLUSION
Our results suggest that the same surgeon performing two LCs for colon cancer on a single day is feasible in terms of short-term and long-term outcomes.
背景
尽管腹腔镜结肠切除术（LC）治疗结肠癌的比例在不断增加，但同一术者在同一天内完成两次 LC 的可行性仍不清楚。本研究旨在通过评估短期和长期结果来阐明这种做法的可行性。
方法
本回顾性分析纳入了 2010 年至 2020 年在静冈癌症中心接受 LC 治疗的病理分期 I-III 期结肠癌患者。根据术者手术时间将患者分为两组。第一组（n=1485）包括术者当天第一台手术为 LC 的患者。第二组（n=163）包括术者当天第二台 LC 为手术的患者。采用倾向评分匹配法平衡两组的基线特征。比较两组的短期和长期结果。
结果
在倾向评分匹配后，第一组（10.4%，17/163）和第二组（5.5%，9/163）术后并发症发生率 Clavien-Dindo 分级 II 级或以上无显著差异。两组间其他围手术期结果，包括手术时间、术中出血量和中转开腹率，均无显著差异。关于长期结果，两组在全队列和倾向评分匹配队列中，总生存率和无复发生存率均无显著差异。在倾向评分匹配队列中，第一组的 5 年总生存率为 92.7%，第二组为 94.4%；5 年无复发生存率分别为 87.1%和 90.3%。
结论
我们的结果表明，同一术者在同一天内为结肠癌行两次 LC 是可行的，且短期和长期结果均良好。
Zotero 插件