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腹腔镜与开腹肝切除术治疗结直肠癌肝转移:一项伞状综述

Laparoscopic versus open liver resection for colorectal liver metastasis: an umbrella review.

作者信息

Pinto Federico, Pangrazio Marco Di, Martinino Alessandro, Todeschini Letizia, Toti Francesco, Cristin Luca, Caimano Miriam, Mattia Amelia, Bianco Giuseppe, Spoletini Gabriele, Giovinazzo Francesco

机构信息

Department of Surgery, University of Illinois at Chicago, Chicago, IL, United States.

Faculty of Medicine and Surgery, University of Verona, Verona, Italy.

出版信息

Front Oncol. 2024 Jul 15;14:1340430. doi: 10.3389/fonc.2024.1340430. eCollection 2024.

Abstract

INTRODUCTION

This study comprehensively compared laparoscopic liver resection (LLR) to open liver resection (OLR) in treating colorectal cancer liver metastasis (CRLM).

METHODS

A systematic review of relevant literature was conducted to assess a range of crucial surgical and oncological outcomes.

RESULTS

Findings indicate that minimally invasive surgery (MIS) did not significantly prolong the duration of surgery compared to open liver resection and notably demonstrated lower blood transfusion rates and reduced intraoperative blood loss. While some studies favored MIS for its lower complication rates, others did not establish a statistically significant difference. One study identified a lower post-operative mortality rate in the MIS group. Furthermore, MIS consistently correlated with shorter hospital stays, indicative of expedited post-operative recovery. Concerning oncological outcomes, while certain meta-analyses reported a lower rate of cancer recurrence in the MIS group, others found no significant disparity. Overall survival and disease-free survival remained comparable between the MIS and open liver resection groups.

CONCLUSION

The analysis emphasizes the potential advantages of LLR in terms of surgical outcomes and aligns with existing literature findings in this field.

SYSTEMATIC REVIEW REGISTRATION

[website], identifier [registration number].

摘要

引言

本研究全面比较了腹腔镜肝切除术(LLR)与开腹肝切除术(OLR)在治疗结直肠癌肝转移(CRLM)方面的效果。

方法

对相关文献进行系统综述,以评估一系列关键的手术和肿瘤学结果。

结果

研究结果表明,与开腹肝切除术相比,微创手术(MIS)并未显著延长手术时间,且明显显示出较低的输血率和术中失血量。虽然一些研究认为MIS因其较低的并发症发生率而更具优势,但其他研究并未发现统计学上的显著差异。一项研究发现MIS组的术后死亡率较低。此外,MIS始终与较短的住院时间相关,这表明术后恢复更快。关于肿瘤学结果,虽然某些荟萃分析报告MIS组的癌症复发率较低,但其他研究未发现显著差异。MIS组与开腹肝切除术组的总生存率和无病生存率仍然相当。

结论

该分析强调了LLR在手术结果方面的潜在优势,与该领域现有文献的研究结果一致。

系统综述注册

[网站],标识符[注册号]。

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