[腹腔镜与开放式左结肠切除术的5年肿瘤学结果]。

Chirurgia italiana Pub Date : 2009-09-01
Luca Maria Siani, Fabrizio Ferranti, Marco Marzano, Antonio De Carlo, Alberto Quintiliani
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引用次数: 0

摘要

腹腔镜左半结肠切除术在外科实践中仍然不常见,因为对肿瘤不充分的不合理的恐惧和技术上的困难和陡峭的学习曲线。本研究的目的是分析我们5年腹腔镜左结肠切除术的经验及其短期和长期的结果。30例非转移性非浸润性左结肠癌患者进行腹腔镜治疗,并与腹腔镜治疗组进行回顾性比较,并在年龄,合并症和疾病分期方面与腹腔镜组相匹配。腹腔镜手术持续时间较长,但术中出血量、胃肠胀气通过和住院时间明显减少。两组发病率相似,均无30天死亡率。标本长度和淋巴结数量相似,5年累积生存曲线无统计学差异(73.1%腹腔镜vs 70.8%开放)。今天,由于担心肿瘤方面的不足和技术上的困难,腹腔镜结肠手术很少进行,但最近的几项试验已经提供了安全性的证据,并且肿瘤结果与开放式手术相当。我们5年的经验证实了这些研究:我们的短期和长期结果显示腹腔镜和“开放”手术之间没有统计学差异。腹腔镜左结肠切除术对于非转移性、非浸润性左结肠癌来说是一种安全、有效且符合肿瘤学要求的手术方法,因此是此类肿瘤手术治疗的有效选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Five-year oncological results of laparoscopic versus open left hemicolectomy].

Laparoscopic left hemicolectomy is still uncommon in surgical practice, because of both an unjustified fear of oncological inadequacy and technical difficulties with a steep learning curve. The aim of the present study was to analyse our 5-year experience with laparoscopic left hemicolectomy and its short- and long-term results. Thirty patients with non-metastatic non-infiltrating left colon cancer were treated laparoscopically and retrospectively compared to a group treated laparotomically and well matched for age, comorbidity and stage of disease in respect to the laparoscopic group. The duration of the laparoscopic procedures was longer, but intraoperative blood loss, passage of flatus and hospital stay were significantly less. Morbidity was similar and there was no 30 days mortality in either group. Specimen length and number of harvested lymph nodes were similar and 5-year cumulative survival curves showed no significant statistical difference (73.1% laparoscopic vs 70.8% open). Today, laparoscopic colon procedures are rarely performed, due both to fear of oncological inadequacy and to technical difficulties, yet several recent trials have presented evidence of safety, and oncological results comparable to those of the open counterpart. Our 5-year experience confirms these studies: our short- and long-term results show no statistical differences between the laparoscopic and "open" procedure. Laparoscopic left hemicolectomy is a safe, effective and oncologically adequate surgical procedure for non-metastatic non-infiltrating left colon cancer and is therefore a valid option for the surgical treatment of these neoplasms.

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