|
|
Comparison of efficacy and safety between laparoscopic assisted and open total mesorectal excision in the treatment of right colon cancer in the elderly |
CUI Yong1, CHENG Shujie2, ZHANG Yanbei3, WANG Qian4, HUO Ran5 |
1. Surgical Oncology, Affiliated Hospital of Hebei University,Baoding 071000,China; 2. Department of General Surgery, Affiliated Hospital of Hebei University,Baoding 071000,China; 3. Petvic Sursery, Baoding No.1 Hospital, BaoDing 071000,China; 4. Department of Pcediatrics,Baoding No.1 Hospital, BaoDing 071000,China; 5. Medical Oncology,Affiliated Hospital of Hebei University,Baoding 071000,China |
|
|
Abstract Objective To evaluate the safety and feasibility of laparoscopic-assisted CME (laparoscopic complete mesocolic excision, LCME) and open CME (open complete mesocolic excision, OCME) in the treatment of elderly patients with right colon cancer. Methods Data was collected retrospectively by reviewing the medical records of 170 patients of right-sided colon cancer who had undergone right colectomy in the Affiliated Hospital of Hebei University between April 2011 and September 2015. The elderly patients were equally divided into LCME group and OCME group based on the approach to colectomy. Demographic variables including age, gender, information on surgery,pathological findings and follow-up were collected and analyzed. Results The median blood loss, median time to anal exhaust, post-operative liquid food, and hospital stay were significantly shorter or lower in LCME group than those in OCME group (P<0.05). The difference of durations of surgery, operation quality grading、cardiac-cerebrovascular accidents,tumor diameter and the number of harvested lymph nodes were not statistically significant between the two groups (P>0.05). After follow-up of 48 months, the rate of local recurrence and distant metastasis showed no significant difference between the two groups (P>0.05). Conclusions LCME is a safe and feasible treatment for elderly patients with right colon cancer. It can facilitate the recovery of postoperative patients.
|
Received: 21 June 2017
|
|
|
|
|
[1] |
Takada H, Ohsawa T, Iwanmoto S, et al . Changing site distribution of colorectal cancer in japan [J]. Dis Colon Rectum, 2002,45:1249-1254.
|
[2] |
Adamina M, Kehlet H, Tomlinson G A, et al . Delaney CP (2011) Enhanced recovery pathways optimize health outcomes and resource utilization: a meta-analysis of rando mized controlled trials in colorectal surgery[J]. Surgery,2012,149:830-840.
|
[3] |
Fullum T M, Ladapo J A, Borah B J. Gunnarsson CL (2010) Comparison of the clinical and economic outcomes between open and minimally invasive append ectomy and colectomy: evidence from a large commercial payer database[J]. Surg Endosc,2010,24(4):845-853.
|
[4] |
孙艳武,池 畔,林惠铭,等.腹腔镜与开腹完整结肠系膜切除术的疗效比较[J].中华胃肠外科杂志,2012,15(1):24-27.
|
[5] |
Hohenberger W,Weber K,Matzel K, et al .Standardized surgery for colonic cancer:complete mesocolic excision and central ligation technical notes and outcome[J].Colorectal Dis,2009,11(4):354-364.
|
[6] |
West N P,Hohenberger W,Weber K, et al .Complete mesocolie excision with central vascular ligation produces an oneologically superior specimen compared with standard surgery for carcinoma of the colon [J].J Clin Oncol,2010,28:272-278.
|
[7] |
Jacobs M, Verdsja J C, Goldstein H S.Minimally invasive colon resection (laparoscopic colectomy) [J].Surg Laparosc Endosc,1991,1(3):144-150.
|
[8] |
李国新,赵丽瑛,张 策. 腹腔镜中间入路法结肠癌根治术[J].中国实用外科杂志,2011,31:538-540.
|
[9] |
Guillou P J, Quirke P, Thorpe H, et al . Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer MRC CLASSIC trial): multicentre, randomised controlled trial[J]. Lancet,2005,365: 1718-1726.
|
[10] |
agtegaal I D, van de Velde C J, van der Worp E, et al . Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control[J]. J Clin Oncol,2002,20: 1729-1734.
|
[11] |
Quirke P, Sebag-Montefi ore D, Steele R, et al . Local recurrence after rectal cancer resection is strongly related to the plane of surgical dissection and is further reduced by preoperative short course radiotherapy[J]. J Clin Oncol, 2006,24 (suppl): A3512.
|
[12] |
Chang G J, Rodriguez-Bigas M A, Skibber J M, et al . Lymph node evaluation and survival after curative resection of colon cancer: systematic review[J]. J Natl Cancer Inst,2007,99:433-441.
|
[13] |
Le Voyer T E, Sigurdson E R, Hanlon A L, et al . Colon cancer survival is associated with increasing number of lymph nodes analyzed : a secondary survey of Intergroup trial INT-0089[J]. J Clin Oncol,2003,21:2912-2919.
|
[14] |
Hohenberger W,Weber K,Matzel K, et al .Standardized surgery for colonic cancer:complete mesocolic excision and central ligation—technical notes and outcome [J].Colorectal Dis,2009,11:354-365.
|
[15] |
Pramateftakis M G.Optimizing colonic cancer surgery:high ligation and complete mesocolic excision during right hemicolectomy [J].Tech coloproctol,2010,14:S49- S51.
|
[16] |
叶颖江,高志冬,王 杉,等.完整结肠系膜切除在结肠癌手术治疗中的应用[J].中华实用外科杂志,2011,31:494-496.
|
[17] |
Veenhof A A,Sietses C,von Blomberg B M, et al .The surgical stress response and postoperative immune function after laparoseopie or conventional total mesoreetal excision in rectal cancer:a randomized trial[J].Int J Colorectal Dis,2011,26:53-59.
|
[18] |
Pooh J T,Law W L,Chow L C, et al .Outcome of laparoseopie resection for eolorectal cancer in patients with hiish operative risk[J].Ann Surg Oncol,2011,18(7):1884-1890.
|
[19] |
Sun Y W, Chi P, Lin H M, et al .Risk factors of postoperative chyle leak following complete mesocolic excision for colon cancer[J]. Zhong hua Wei Chang Wai Ke Za Zhi,2012,5:328-331.
|
[20] |
Kitano S, Kitajima M, Konishi F, et al . A multicenter study on laparoscopic urgery for colorectal cancer in Japan[J]. Surg Endosc,2006,20:1348-1352.
|
[21] |
Evans C,Galustian C,Kumar D, et al .Impact of surgery on immunologic function:comparison between minimally invasive[J]. Am J Surg,2009,197(2):238-245.
|
|
|
|