Short-term outcomes following reduced-port, single-port, and multi-port laparoscopic surgery for colon cancer: tailored laparoscopic approaches based on tumor size and nodal status
Short-term outcomes following reduced-port, single-port, and multi-port laparoscopic surgery for colon cancer: tailored laparoscopic approaches based on tumor size and nodal status
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DOI：
10.1007/s00384-015-2399-z
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发表时间：
2016-01-01
影响因子：
2.8
通讯作者：
Shin, Jin Yong
中科院分区：
文献类型：
--
作者：
Yu, Hyeon;Shin, Jin Yong
外科医生最近开发了更微创的外科手术，以减少手术压力并改善美容效果。尽管单孔腹腔镜结肠切除术（SPLC）比多孔腹腔镜结肠切除术（MPLC）具有潜在的益处，但仍存在与SPLC相关的技术难度增加的担忧。因此，我们尝试了缩口腹腔镜结肠切除术（RPLC）。本研究的目的是评估根据肿瘤特征进行定制腹腔镜手术治疗结肠癌的围手术期结局的差异，回顾性分析了2010年7月至2013年6月期间170例仅接受微创结肠切除术的结肠癌患者的前瞻性数据。MPLC、SPLC和RPLC组包括92个（54.1%）、40（23.5%），38 RPLC组的淋巴结收获数显著高于MPLC组和SPLC组（分别为29.9 ± 21.5、21.9 ± 12.1和24.2 ± 13.8; p = 0.027）。MPLC、SPLC和RPLC组的平均手术时间存在显着差异（分别为243.5 +/- 59.0、207.2 +/- 49.6和216.2 +/- 53.7分钟; p = 0.001）。MPLC、SPLC和RPLC组之间至首次排气的时间也存在显著差异（分别为3.1 +/- 1.2、3.6 +/- 1.3和3.4 +/- 1.1天; p = 0.039）。根据结肠癌的腹腔镜手术方式，SPLC和RPLC在手术时间和淋巴结回收方面似乎是有益的，可以考虑作为具有良好肿瘤特征的结肠癌患者的腹腔镜结肠切除术的手术选择。
Surgeons have recently developed more minimally invasive surgical procedures to reduce surgical stress and improve cosmesis. Although single-port laparoscopic colectomy (SPLC) has potential benefits over multi-port laparoscopic colectomy (MPLC), there are concerns about the increased technical difficulties associated with SPLC. Therefore, we attempted reduced-port laparoscopic colectomy (RPLC). The purpose of this study was to evaluate the difference in perioperative outcome following tailored laparoscopic approaches for colon cancer on the basis of tumor characteristics.The prospectively collected data of 170 patients who underwent only minimally invasive colectomy for colon cancer from July 2010 to June 2013 were reviewed. The MPLC, SPLC, and RPLC groups comprised 92 (54.1 %), 40 (23.5 %), and 38 (22.4 %) patients, respectively.The number of harvested lymph nodes was significantly higher in the RPLC group than in the MPLC and SPLC groups (29.9 +/- 21.5, 21.9 +/- 12.1, and 24.2 +/- 13.8, respectively; p = 0.027). The mean operating time was significantly different among the MPLC, SPLC, and RPLC groups (243.5 +/- 59.0, 207.2 +/- 49.6, and 216.2 +/- 53.7 min, respectively; p = 0.001). The time to first flatus was also significantly different among the MPLC, SPLC, and RPLC groups (3.1 +/- 1.2, 3.6 +/- 1.3, and 3.4 +/- 1.1 days, respectively; p = 0.039). No significant differences in the other short-term surgical outcomes were observed among the three groups.SPLC and RPLC according to tailored laparoscopic approaches for colon cancer appear to be beneficial in terms of operative time and lymph node retrieval, and may be considered as surgical options in laparoscopic colectomy for colon cancer patients with favorable tumor characteristics.