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与T3 - T4a期结肠癌腹腔镜手术相关的技术、围手术期结局、预后及生存情况

Techniques, perioperative outcomes, prognosis, and survival associated with laparoscopic surgery for T3-T4a colon cancer.

作者信息

Zhang Sheng-Ni, Lu Lu, Lou Cun-Guang, Wei Ya-Ning, Zhang Tao, Liu Xiao-Rui

机构信息

Department of Dermatology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China.

Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China.

出版信息

World J Gastrointest Oncol. 2025 May 15;17(5):103418. doi: 10.4251/wjgo.v17.i5.103418.

Abstract

BACKGROUND

The efficacy of laparoscopic surgery for the treatment of T3-T4a colon cancer remains a subject of debate in the medical community.

AIM

To explore the surgical techniques, perioperative outcomes, follow-up results, patient prognosis, and survival status associated with laparoscopic surgery for T3-T4a colon cancer.

METHODS

A total of 202 patients with T3-T4a colon cancer treated at the Affiliated Hospital of Hebei University between January 2020 and December 2024 were selected for this study and divided into two groups based on the type of surgery: Open surgery group (101 cases) and laparoscopic surgery group (LAP group, 101 cases). Perioperative indicators (surgical time, postoperative drainage, first flatus, hospital stay, intraoperative blood loss, and number of lymph nodes removed), disease-free survival, and overall survival at 1-year and 3-year follow-ups, as well as the incidence of complications, were compared between the two groups.

RESULTS

The LAP group had longer surgical times and a greater number of lymph nodes removed compared to the open surgery group ( < 0.05). The LAP group also had less blood loss, shorter drainage time, faster time to flatus, and a lower incidence of complications compared to the open surgery group ( < 0.05). There was no significant difference in hospital stay, disease-free survival, or overall survival between the two groups during the follow-up period, and this remained true even after adjusting for subgroups based on left-sided colon, right-sided colon, and T4a stage ( > 0.05).

CONCLUSION

The long-term outcomes of laparoscopic radical surgery for T3-T4a colon cancer are comparable to those of open surgery and can accelerate patient recovery and reduce the risk of short-term complications, offering better immediate outcomes.

摘要

背景

腹腔镜手术治疗T3 - T4a期结肠癌的疗效在医学界仍是一个有争议的话题。

目的

探讨腹腔镜手术治疗T3 - T4a期结肠癌的手术技术、围手术期结果、随访结果、患者预后及生存状况。

方法

选取2020年1月至2024年12月在河北大学附属医院接受治疗的202例T3 - T4a期结肠癌患者进行本研究,根据手术方式分为两组:开放手术组(101例)和腹腔镜手术组(LAP组,101例)。比较两组的围手术期指标(手术时间、术后引流、首次排气、住院时间、术中出血量及清扫淋巴结数目)、无病生存期、1年和3年随访时的总生存期以及并发症发生率。

结果

与开放手术组相比,LAP组手术时间更长,清扫淋巴结数目更多(<0.05)。与开放手术组相比,LAP组术中出血量更少、引流时间更短、首次排气时间更快且并发症发生率更低(<0.05)。随访期间两组住院时间、无病生存期或总生存期无显著差异,基于左半结肠区、右半结肠区和T4a期进行亚组调整后结果依然如此(>0.05)。

结论

腹腔镜根治性手术治疗T3 - T4a期结肠癌的长期疗效与开放手术相当,可加速患者康复并降低短期并发症风险,近期疗效更佳。

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