Utilization of Laparoscopy in Colorectal Surgery for Cancer at Academic Medical Centers: Does Site of Surgery Affect Rate of Laparoscopy?
Utilization of Laparoscopy in Colorectal Surgery for Cancer at Academic Medical Centers: Does Site of Surgery Affect Rate of Laparoscopy?
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学术医疗中心在结直肠癌手术中使用腹腔镜手术：手术部位是否会影响腹腔镜手术率？
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
N. Nguyen
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文献类型：
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作者：
J. Carmichael;H. Masoomi;S. Mills;M. Stamos;N. Nguyen
腹腔镜术在结直肠癌手术中的应用仍然有限。这项研究的目的是确定学术医学中心的腹腔镜结直肠癌手术的使用率，并评估手术部位是否影响使用率。2007年至2009年接受腹腔镜或开腹结肠癌和直肠切除术的癌症患者的临床数据来自大学卫生系统联盟数据库。获得了关于腹腔镜率、住院时间、发病率和风险调整死亡率的数据。在36个月的研究期间，共进行了22,780例手术。腹腔镜术的总使用率为14.8%。全结肠切除术(22.6%)、乙状结肠切除术(17.3%)、盲肠切除术(17.1%)、右半结肠切除术(17.0%)。腹会切除术(8.0%)、横结肠切除术(10.0%)和左半结肠切除术(13.1%)最少见。腹腔镜结肠和直肠手术的住院时间比开腹手术短3.2天。尽管腹腔镜结直肠癌手术的好处已得到证明，但结肠癌和直肠癌的结直肠癌手术中，使用腹腔镜进行结直肠癌切除术的比例仍不到20%，直肠癌的比例也不到10%。需要进一步的研究来确定限制腹腔镜在结直肠手术中使用的因素。
Use of laparoscopy in colorectal cancer surgery is still limited. The aim of this study was to determine the rate of use of laparoscopic colorectal surgery for cancer at academic medical centers and to evaluate if the site of surgery influences the rate of use. Clinical data of patients who underwent laparoscopic or open colon and rectal resections for cancer from 2007 to 2009 were obtained from the University HealthSystem Consortium database. Data concerning rate of laparoscopy, length of stay, morbidity, and risk-adjusted mortality were obtained. During the 36-month study period, 22,780 operations were performed. The overall rate for use of laparoscopy was 14.8 per cent. Laparoscopy was most often used for total colectomy (22.6%), sigmoid colectomy (17.3%), cecectomy (17.1%), and right hemicolectomy (17.0%). Laparoscopy was most infrequently used for abdominoperineal resection (8.0%), transverse colectomy (10.0%), and left hemicolectomy (13.1%). Length of stay for laparoscopic colon and rectal procedures was 3.2 days shorter than for open surgery. Although the benefits of laparoscopic colorectal surgery for cancer have been demonstrated, the use of laparoscopy for colorectal resection remains under 20 per cent for colon cancer and under 10 per cent for rectal cancer. Further studies are needed to determine the factors limiting the use of laparoscopy in colorectal surgery.