Kim Kyeong Eui, Lee Yoo Jin, Lee Ju Yup, Jeong Woon Kyung, Baek Seong Kyu, Bae Sung Uk
Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Korean J Clin Oncol. 2022 Jun;18(1):47-55. doi: 10.14216/kjco.22006. Epub 2022 Jun 30.
Endoscopic treatment and laparoscopic surgery are minimally invasive options for early treatment of colorectal cancer, however, more evidence of the long-term outcomes between the two procedures is needed to guide clinical decisions. Therefore, this study aimed to compare the oncologic outcomes between endoscopic and laparoscopic treatment for early colorectal cancer.
The study group included 60 patients who underwent endoscopic treatment and 38 patients who underwent laparoscopic surgery for early colorectal adenocarcinoma between January 2010 and December 2013 at a single study site.
Histopathological diagnoses showed that 43 (78.3%) carcinomas in the endoscopic submucosal dissection group were mucosal to sm1, 13 (21.7%) were sm2 or deeper, and 17 high-risk cases (28.3%) in the endoscopic group underwent additional surgery. The median operation time, time to sips of water, and length of hospital stay were significantly shorter in the endoscopic group than in the laparoscopic group. The overall survival rates of patients in the endoscopic group and laparoscopic groups were 91.5% and 87.4%, respectively (P=0.391), and the disease-free survival rates were 90.4% and 87.4% (P=0.614), respectively. Systemic recurrences occurred in two patients (1.6%) in the endoscopic group and one patient (2.0%) in the laparoscopic group. Local recurrence combined with systemic recurrence in one patient (0.8%) in the endoscopic group.
Endoscopic resection for early colorectal cancer can be performed safely with better short-term outcomes and comparable long-term oncological outcomes compared to laparoscopic surgery.
内镜治疗和腹腔镜手术是早期结直肠癌治疗的微创选择，然而，需要更多关于这两种手术长期结局的证据来指导临床决策。因此，本研究旨在比较早期结直肠癌内镜治疗和腹腔镜治疗的肿瘤学结局。
研究组包括2010年1月至2013年12月在单一研究地点接受早期结直肠腺癌内镜治疗的60例患者和接受腹腔镜手术的38例患者。
组织病理学诊断显示，内镜黏膜下剥离组43例（78.3%）癌为黏膜至sm1，13例（21.7%）为sm2或更深，内镜组17例高危病例（28.3%）接受了额外手术。内镜组的中位手术时间、饮水时间和住院时间显著短于腹腔镜组。内镜组和腹腔镜组患者的总生存率分别为91.5%和87.4%（P=0.391），无病生存率分别为90.4%和87.4%（P=0.614）。内镜组2例患者（1.6%）发生全身复发，腹腔镜组1例患者（2.0%）发生全身复发。内镜组1例患者（0.8%）发生局部复发合并全身复发。
与腹腔镜手术相比，早期结直肠癌的内镜切除可以安全地进行，短期结局更好，长期肿瘤学结局相当。
