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减少端口腹腔镜手术与传统腹腔镜手术治疗结直肠癌的疗效和安全性比较

Efficacy and safety of reduced-port laparoscopic surgery versus conventional laparoscopic surgery for colorectal cancer.

作者信息

Liu Zhi-Min, Yao Qi-Jun, Pei Fengyun, He Fang, Zhao Yandong, Huang Jun

机构信息

Department of Colorectal Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancun Erheng Road, Guangzhou, 510655, Guangdong, China.

Biomedical Innovation Centre, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.

出版信息

BMC Cancer. 2025 Feb 1;25(1):187. doi: 10.1186/s12885-025-13585-3.

Abstract

BACKGROUND

Laparoscopic radical resection has become the most important treatment for resectable colorectal cancer (CRC). However, there is still a lack of researches on the efficacy and safety of reduced-port laparoscopic surgery (RPLS) versus conventional laparoscopic surgery (CLS) in the treatment of CRC.

PATIENTS AND METHODS

From January 2019 to July 2022, 698 patients with CRC received surgical treatment in the Sixth Affiliated Hospital of Sun Yat-sen University were enrolled in this retrospective cohort study. Patients were divided into RPLS group (n = 220) and CLS group (n = 478) according to their surgical procedures. Propensity score matching (PSM) was used to adjust the differences in baseline characteristics. The incidence of perioperative outcomes and survival rates related results were analyzed after PSM.

RESULTS

Four hundred twenty-two patients were equally divided into RPLS group (n = 211) and CLS group (n = 211) after PSM. There were no statistically significant differences in overall survival (OS) and progression-free survival (PFS) between the two groups (P value was 0.773 and 0.579 respectively). The perioperative outcomes of patients between the two groups were comparable, except that patients in the RPLS group had a shorter postoperative hospital stay (P value < 0.001).

CONCLUSION

For patients with CRC, both RPLS and CLS might be acceptable surgical options. No significant differences in perioperative outcomes, PFS rates and OS rates were observed between the two groups. For certain cases, RPLS was superior to CLS in terms of postoperative recovery.

摘要

背景

腹腔镜根治性切除术已成为可切除结直肠癌(CRC)最重要的治疗方法。然而,关于减少端口腹腔镜手术(RPLS)与传统腹腔镜手术(CLS)治疗CRC的疗效和安全性仍缺乏研究。

患者与方法

2019年1月至2022年7月,中山大学附属第六医院698例接受手术治疗的CRC患者纳入本回顾性队列研究。根据手术方式将患者分为RPLS组(n = 220)和CLS组(n = 478)。采用倾向评分匹配(PSM)调整基线特征差异。PSM后分析围手术期结局发生率和生存率相关结果。

结果

PSM后422例患者被等分为RPLS组(n = 211)和CLS组(n = 211)。两组间总生存期(OS)和无进展生存期(PFS)无统计学显著差异(P值分别为0.773和0.579)。两组患者围手术期结局具有可比性,除RPLS组患者术后住院时间较短(P值<0.001)。

结论

对于CRC患者,RPLS和CLS可能都是可接受的手术选择。两组间围手术期结局、PFS率和OS率无显著差异。在某些情况下,RPLS在术后恢复方面优于CLS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c9e/11786425/0d6106ad1433/12885_2025_13585_Fig1_HTML.jpg

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