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巴基斯坦白沙瓦一家高容量中心的腹腔镜直肠癌手术短期结果

Short-Term Outcomes of Laparoscopic Rectal Cancer Surgery at a High-Volume Center in Peshawar, Pakistan.

作者信息

Abbasi Hussain Jan, Ahmad Riaz, Abid Haider, Hussain Saddam, Saeed Aziz Sarmad, Fahd Shah Muhammad, Nasir Irfan Ul Islam

机构信息

Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Peshawar, PAK.

Colorectal Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Peshawar, PAK.

出版信息

Cureus. 2025 Mar 25;17(3):e81133. doi: 10.7759/cureus.81133. eCollection 2025 Mar.

Abstract

BACKGROUND

Rectal cancer is a serious worldwide health issue, and laparoscopic surgery is becoming a common therapeutic choice because of its advantages, which include less pain after surgery, quicker recovery, and oncological results that are comparable to those of open surgery. Even though laparoscopic rectal cancer surgery has proven successful in developed countries, it is still not well-studied in places with low resources, like Pakistan.

OBJECTIVE

The primary objective of this study was to evaluate the clinical outcomes and surgical efficacy of laparoscopic rectal cancer surgery in 209 patients, focusing on operative details, histopathological findings, and postoperative complications. The secondary objective was to assess 90-day disease-free survival (DFS), mortality rates, and the need for reexploration or readmission.

MATERIALS AND METHODS

This retrospective observational study was performed at the Surgical Oncology department, Shaukat Khanum Memorial Cancer Hospital, Peshawar, a high-volume center for colorectal surgery. Assessment of short-term surgical results of laparoscopic rectal cancer operation ensued from April 1, 2021, to March 31, 2024. The sample comprised 209 patients with rectal cancer who were treated by laparoscopic rectal cancer surgery. A consecutive sampling technique was used to enroll eligible patients during the study duration.

RESULTS

The mean age of the patients was 43.07 ± 22.1 years. The male-to-female ratio was 1.4:1, with males comprising 131 patients (62.7%) and females, 78 patients (37.3%). The regional distribution included 54 (25.8%) from Afghanistan, 11 (5.2%) from the federally administered tribal area (FATA), 141 (67.5%) from Khyber Pakhtunkhwa (KPK), and three (1.4%) from Punjab. Preoperative assessment classified 191 (91.4%) patients as American Society of Anesthesiologists (ASA)-II, and 18 (8.6%) cases as ASA-III.

CONCLUSION

Laparoscopic rectal cancer surgery demonstrates favorable short-term outcomes, including minimal morbidity, low conversion rates, and promising oncological results in a high-volume center in Peshawar, Pakistan. These findings support the feasibility of laparoscopic surgery for rectal cancer in resource-constrained settings.

摘要

背景

直肠癌是一个严重的全球性健康问题,腹腔镜手术因其具有术后疼痛轻、恢复快以及肿瘤学效果与开放手术相当等优势,正成为一种常见的治疗选择。尽管腹腔镜直肠癌手术在发达国家已被证明是成功的,但在资源匮乏地区,如巴基斯坦,对其研究仍较少。

目的

本研究的主要目的是评估209例患者腹腔镜直肠癌手术的临床结果和手术疗效,重点关注手术细节、组织病理学发现和术后并发症。次要目的是评估90天无病生存率(DFS)、死亡率以及再次探查或再次入院的必要性。

材料与方法

本回顾性观察研究在白沙瓦的绍卡特·汗姆纪念癌症医院外科肿瘤学部门进行,该部门是结直肠手术的高容量中心。对2021年4月1日至2024年3月31日期间腹腔镜直肠癌手术的短期手术结果进行评估。样本包括209例接受腹腔镜直肠癌手术治疗的直肠癌患者。在研究期间采用连续抽样技术纳入符合条件的患者。

结果

患者的平均年龄为43.07±22.1岁。男女比例为1.4:1,男性131例(62.7%),女性78例(37.3%)。地区分布包括来自阿富汗的54例(25.8%)、联邦直辖部落地区(FATA)的11例(5.2%)、开伯尔-普赫图赫瓦省(KPK)的141例(67.5%)以及旁遮普省的3例(1.4%)。术前评估将191例(91.4%)患者分类为美国麻醉医师协会(ASA)-II级,18例(8.6%)病例分类为ASA-III级。

结论

在巴基斯坦白沙瓦的一个高容量中心,腹腔镜直肠癌手术显示出良好的短期结果,包括发病率极低、转化率低以及有前景的肿瘤学效果。这些发现支持了在资源有限环境下腹腔镜手术治疗直肠癌的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/331f/12019900/ddb34e19e3e7/cureus-0017-00000081133-i01.jpg

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