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中结肠中段癌的最佳手术入路:系统评价和荟萃分析。

Optimal surgical approach for mid-transverse colon cancer: a systematic review and meta-analysis.

机构信息

General Surgery Department, Ain Shams University Hospital, Cairo, Egypt.

Faculty of Medicine, Ain Shams University Hospital, Cairo, Egypt.

出版信息

Int J Clin Oncol. 2024 Jun;29(6):706-715. doi: 10.1007/s10147-024-02486-3. Epub 2024 Apr 29.

Abstract

BACKGROUND AND AIM

The incidence of cancer colon has increased dramatically. In addition, the database lacks a review to analyze the outcomes of surgeries for mid-transverse colon cancer with several recent controversial studies. We aimed to compare the outcomes of extended hemicolectomy versus transverse colectomy for mid-transverse colon cancer.

METHOD

PubMed, Scopes, Web of Science and Cochrane Library were searched for eligible studies from inception to 1 December 2022 and a systematic review and meta-analysis were done to detect.

RESULTS

According to eligibility criteria, 8 studies (2237 patients) were included in our study. The pooled results of the included studies showed no difference in the 5-year OS, 3-year DFS and 5-year DFS between the two types of surgery (5-year OS, RR = 1.15, 95% CI 0.94-1.39, P = 0.17), (3-year OS, RR = 0.96, 95% CI 0.88-1.06, P = 0.42) and (5-year DFS, RR = 1.21, 95% CI 0.91-1.62, P = 0.20). In addition to that, the recurrence rate and the incidence of complications were similar in the two groups (Recurrence rate, RR = 1.08, 95% CI 0.62-1.89, P = 0.79) and (Complications, RR = 1.07, 95% CI 0.74-1.54, P = 0.72). However, the number of LN harvest and the time of the operation were more in case of extended hemicolectomy.

CONCLUSION

Despite harvesting less LN, transverse colectomy has similar oncological outcomes to extended hemicolectomy for mid-transverse colon cancer. In addition to that, there was no significant difference in the incidence of complications between the two surgeries.

摘要

背景与目的

结肠癌的发病率显著增加。此外,由于数据库缺乏对几项最近有争议的研究进行分析的综述,因此缺乏对中段横结肠癌手术结果的回顾。我们旨在比较扩大右半结肠切除术与横结肠切除术治疗中段横结肠癌的效果。

方法

检索 PubMed、Scopus、Web of Science 和 Cochrane Library 自成立至 2022 年 12 月 1 日的相关研究,并进行系统评价和荟萃分析。

结果

根据纳入标准,共有 8 项研究(2237 例患者)纳入本研究。纳入研究的汇总结果显示,两种手术方式在 5 年总生存率、3 年无病生存率和 5 年无病生存率方面无差异(5 年总生存率,RR=1.15,95%CI 0.94-1.39,P=0.17),(3 年总生存率,RR=0.96,95%CI 0.88-1.06,P=0.42)和(5 年无病生存率,RR=1.21,95%CI 0.91-1.62,P=0.20)。此外,两组的复发率和并发症发生率相似(复发率,RR=1.08,95%CI 0.62-1.89,P=0.79)和(并发症,RR=1.07,95%CI 0.74-1.54,P=0.72)。然而,扩大右半结肠切除术的淋巴结清扫数目和手术时间更多。

结论

尽管淋巴结清扫数目较少,但横结肠切除术与扩大右半结肠切除术治疗中段横结肠癌的肿瘤学结果相似。此外,两种手术的并发症发生率无显著差异。

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