Cook T A, Dehn T C
Department of Surgery, Royal Berkshire Hospital, Reading, UK.
Br J Surg. 1996 Oct;83(10):1419-20. doi: 10.1002/bjs.1800831031.
Laparoscopic colonic resection and laparoscopy for the assessment of malignant disease have been advocated. Metastatic deposits at port sites are recognized but the incidence of these is poorly defined. Forty-six patients, of median age 65 (range 19-90) years, with gastrointestinal malignancy underwent laparoscopy. Eighteen patients died a median of 4 (range 1-28) months after laparoscopy, four following colonic resection and 14 with gastro-oesophageal malignancy; ten had undergone resection. Median follow-up of the 28 survivors is 8 (range 2-39) months. Five of the 46 patients developed port-site recurrence giving an early incidence of port-site recurrence in this cohort of patients of 11 per cent. Five of 20 patients with tumour involving serosal surfaces developed port-site recurrence compared with none of 26 without serosal involvement (P = 0.022, Fisher's exact test). Port-site recurrence may be related to serosal involvement with tumour.
腹腔镜结肠切除术以及用于评估恶性疾病的腹腔镜检查已得到提倡。端口部位的转移瘤已得到确认,但这些转移瘤的发生率尚不明确。46例中位年龄为65岁(范围19 - 90岁)的胃肠道恶性肿瘤患者接受了腹腔镜检查。18例患者在腹腔镜检查后中位4个月(范围1 - 28个月)死亡,4例在结肠切除术后死亡,14例因胃食管恶性肿瘤死亡;其中10例接受了切除术。28名幸存者的中位随访时间为8个月(范围2 - 39个月)。46例患者中有5例发生端口部位复发,该队列患者的端口部位复发早期发生率为11%。20例肿瘤累及浆膜表面的患者中有5例发生端口部位复发,而26例未累及浆膜的患者中无一例发生端口部位复发(P = 0.022,Fisher精确检验)。端口部位复发可能与肿瘤累及浆膜有关。