Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China.
Cancer Control. 2023 Jan-Dec;30:10732748231210676. doi: 10.1177/10732748231210676.
The purpose of this study was to investigate the effect of laparoscopic left colectomy (LLC) and laparoscopic sigmoidectomy (LSD) on short-term outcomes and prognosis of sigmoid colon cancer (SCC) patients using propensity score matching (PSM).
In this retrospective study, the SCC patients who underwent LLC or LSD surgery were collected from a single clinical center from Jan 2011 to Dec 2019. Short-term outcomes and prognosis were compared between patients who received LSD surgery and LLC surgery.
A total of 356 patients were included in this study. After 1:1 PSM analysis, there were 50 patients who underwent LLC surgery and 50 patients who underwent LSD surgery left in this study. No significant difference was found in baseline characteristics after PSM ( > .05). In comparison with the LLC surgery group, the LSD surgery group had shorter operation time ( = .003) after PSM. Moreover, the surgical procedure was not an independent predictor for overall survival (OS) ( = .918, 95% CI = .333-2.688) and disease-free survival DFS ( = .730, 95% CI = .335-2.150), but age (OS: = .009, 95% CI = 1.010-1.075; DFS: = .014, 95% CI = 1.007-1.061) and tumor stage (OS: = .004, 95% CI = 1.302-3.844; DFS: < .01, 95% CI = 1.572-4.171) were the independent risk factors for OS and DFS in SCC patients.
There was no significant difference between the two surgical procedures for prognosis of SCC patients. However, the possible reasons for changing the surgical procedures should be cautious by surgeons.
本研究旨在通过倾向评分匹配(PSM)探讨腹腔镜左半结肠切除术(LLC)和腹腔镜乙状结肠切除术(LSD)对乙状结肠癌(SCC)患者短期结局和预后的影响。
本回顾性研究收集了 2011 年 1 月至 2019 年 12 月在单一临床中心接受 LLC 或 LSD 手术的 SCC 患者。比较接受 LSD 手术和 LLC 手术的患者之间的短期结局和预后。
本研究共纳入 356 例患者。经 1:1 PSM 分析后,本研究中 LLC 手术组和 LSD 手术组各有 50 例患者。PSM 后两组基线特征无显著差异(>.05)。PSM 后,与 LLC 手术组相比,LSD 手术组的手术时间更短(=.003)。此外,手术方式不是总生存(OS)(=.918,95%CI =.333-2.688)和无病生存(DFS)(=.730,95%CI =.335-2.150)的独立预测因素,但年龄(OS:=.009,95%CI = 1.010-1.075;DFS:=.014,95%CI = 1.007-1.061)和肿瘤分期(OS:=.004,95%CI = 1.302-3.844;DFS:<.01,95%CI = 1.572-4.171)是 SCC 患者 OS 和 DFS 的独立危险因素。
两种手术方式对 SCC 患者的预后无显著差异。然而,外科医生应谨慎考虑改变手术方式的可能原因。