Leung K L, Kwok S P, Lau W Y, Meng W C, Lam T Y, Kwong K H, Chung C C, Li A K
Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Arch Surg. 1997 Jul;132(7):761-4; discussion 765. doi: 10.1001/archsurg.1997.01430310075015.
The technique of laparoscopic-assisted resection of colorectal carcinoma has been established. However, whether such a procedure is beneficial to patients is uncertain.
To review the immediate and medium-term results of laparoscopic-assisted resection in patients with rectosigmoid carcinoma.
We attempted laparoscopic-assisted sigmoid colectomy or anterior resection in 50 patients with rectosigmoid carcinoma (ie, the study group). The results were compared with those of 50 matched patients who underwent conventional open resection in the immediate prelaparoscopic era (ie, the control group).
The median follow-up times for the study and control groups were 32.8 and 39.1 months, respectively. The operating time was significantly longer (P < .001, Student t test), while the analgesic requirement was significantly less (P < .001, Mann-Whitney U test) and the duration of hospitalization was significantly shorter (P = .001, Mann-Whitney U test), in the study group than in the control group. The oncological clearance (ie, the number of lymph nodes removed and the distal resection margin), the complication rate, the disease-free rate, and the survival rate were comparable in the 2 groups.
The immediate and medium-term results of laparoscopic-assisted resection of rectosigmoid carcinoma are promising.
腹腔镜辅助结直肠癌切除术技术已确立。然而,该手术对患者是否有益尚不确定。
回顾腹腔镜辅助切除乙状结肠癌患者的近期和中期结果。
我们尝试对50例乙状结肠癌患者进行腹腔镜辅助乙状结肠切除术或前切除术(即研究组)。将结果与在腹腔镜手术前即刻接受传统开放切除术的50例匹配患者(即对照组)的结果进行比较。
研究组和对照组的中位随访时间分别为32.8个月和39.1个月。研究组的手术时间显著更长(P <.001,学生t检验),而镇痛需求显著更少(P <.001,曼-惠特尼U检验),住院时间显著更短(P =.001,曼-惠特尼U检验)。两组的肿瘤学切缘(即切除的淋巴结数量和远端切缘)、并发症发生率、无病生存率和总生存率相当。
腹腔镜辅助切除乙状结肠癌的近期和中期结果令人满意。