Comparison of minimally invasive and open colorectal resections for patients undergoing simultaneous R0 resection for liver metastases: a propensity score analysis
Comparison of minimally invasive and open colorectal resections for patients undergoing simultaneous R0 resection for liver metastases: a propensity score analysis
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DOI：
10.1007/s00384-014-2089-2
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发表时间：
2015-03-01
影响因子：
2.8
通讯作者：
Xu, Jianmin
中科院分区：
文献类型：
--
作者：
Lin, Qi;Ye, Qinghai;Xu, Jianmin
微创结直肠切除术在同时切除肝转移的患者中的作用尚未确定。这项研究比较了接受同时切除肝转移瘤的患者的微创和开放结直肠切除术的短期和长期结局。这项研究回顾了2008年1月至2012年12月期间接受同时结直肠切除术和同步肝转移瘤R 0切除术的101名连续患者。在这项研究中，36例接受微创结直肠切除术的连续患者与36例接受开放手术的患者通过倾向评分相匹配。分析的变量包括患者和肿瘤特征以及短期和长期结局。经过倾向评分匹配，两组具有相似的临床病理变量。接受微创手术的患者均未转为开放手术。两组均未发生术后死亡。微创组的估计失血量（P < 0.007）、肠功能恢复时间（P < 0.016）和术后住院时间（P < 0.011）均显著低于开放组，但手术时间显著延长（P < 0.001）。两组术后并发症无显著差异。两组5年总生存率（51 vs. 55%; P = 0.794）和无病生存率（38 vs. 27%; P = 0.860）无显著差异。微创结直肠切除术同时切除肝转移瘤的结局与开放手术相似，但有一些短期优势。
The role of minimally invasive colorectal resection for patients undergoing a simultaneous resection for synchronous liver metastases had not been established. This study compared the short- and long-term outcomes between minimally invasive and open colorectal resection for patients undergoing simultaneous resection for liver metastases.This study reviewed 101 consecutive patients undergoing simultaneous colorectal resection and R0 resection of synchronous liver metastases between January 2008 and December 2012. In the study, 36 consecutive patients who underwent minimally invasive colorectal resection were matched with 36 patients who had an open approach by propensity scoring. The analyzed variables included patient and tumor characteristics and short-term and long-term outcomes.After propensity score matching, the two groups had similar clinicopathologic variables. No patient undergoing the minimally invasive procedure experienced conversion to the open technique. No postoperative mortality occurred in either group. In the minimally invasive group, the estimated blood loss (P < 0.007), bowel function return time (P < 0.016), and postoperative hospital stay (P < 0.011) were significantly lower than those in the open group, although the operating time was significantly longer (P < 0.001). No significant differences in postoperative complications were observed between the groups. The two groups did not differ significantly in terms of the 5-year overall survival rate (51 vs. 55 %; P = 0.794) and disease-free survival rate (38 vs. 27 %; P = 0.860).Minimally invasive colorectal resection with simultaneous resection of liver metastases has an outcome similar to open approach but some short-term advantages.