腹腔镜与开放手术治疗直肠神经内分泌肿瘤：多中心真实世界研究。

Laparoscopic versus open surgery for rectal neuroendocrine tumors: a multicenter real-world study.

机构信息

Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, no. 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, China.

Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

BMC Cancer. 2024 Aug 5;24(1):956. doi: 10.1186/s12885-024-12711-x.

DOI:10.1186/s12885-024-12711-x

PMID:39103766

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11302294/

Abstract

BACKGROUND

Owing to the lack of evidence-based medical studies with large sample sizes, the surgical approach for the radical resection of rectal neuroendocrine tumors remains controversial.

METHODS

We retrospectively collected the medical records of patients with rectal neuroendocrine tumors who underwent radical resection at 17 large tertiary care hospitals in China between January 1, 2010, and April 30, 2022. All patients were divided into laparoscopic and open surgery groups. After propensity score matching to reduce confounders, the postoperative and oncologic outcomes were compared between the groups.

RESULTS

We enrolled 174 patients with rectal neuroendocrine tumors who underwent radical surgery. After random matching, 124 patients were included in the comparison (62, laparoscopic surgery group; 62, open surgery group). The laparoscopic surgery group had fewer complications (14.5% vs. 35.5%, P = 0.007) and superior relapse-free survival (P = 0.048). Subgroup analysis revealed that the laparoscopic surgery group had fewer complications (10.9% vs. 34.7%, P = 0.004), shorter postoperative hospital stays (9.56 ± 5.21 days vs. 12.31 ± 8.61 days, P = 0.049) and superior relapse-free survival (P = 0.025) in the rectal neuroendocrine tumors ≤ 4 cm subgroup.

CONCLUSIONS

Laparoscopic surgery was associated with improved postoperative outcomes and oncologic prognosis for patients with rectal neuroendocrine tumors ≤ 4 cm; it can serve as a safe and feasible option for radical surgery of rectal neuroendocrine tumors.

摘要

背景

由于缺乏大样本量的基于证据的医学研究，直肠神经内分泌肿瘤的根治性切除手术方法仍存在争议。

方法

我们回顾性收集了 2010 年 1 月 1 日至 2022 年 4 月 30 日期间在中国 17 家大型三级医疗机构接受直肠神经内分泌肿瘤根治性切除术的患者的病历。所有患者均分为腹腔镜组和开放手术组。通过倾向评分匹配以减少混杂因素后，比较两组患者的术后和肿瘤学结果。

结果

我们纳入了 174 例接受直肠神经内分泌肿瘤根治性手术的患者。经过随机匹配，有 124 例患者纳入比较（腹腔镜手术组 62 例，开放手术组 62 例）。腹腔镜手术组的并发症更少（14.5% vs. 35.5%，P=0.007），无复发生存率更高（P=0.048）。亚组分析显示，腹腔镜手术组的并发症更少（10.9% vs. 34.7%，P=0.004），术后住院时间更短（9.56±5.21 天 vs. 12.31±8.61 天，P=0.049），无复发生存率更高（P=0.025）在直肠神经内分泌肿瘤≤4cm 亚组中。