AIM: Laparoscopic surgery, especially laparoscopic rectal surgery, for colorectal cancer has been developed considerably. However, due to relatively complicated anatomy and high requirements for surgery techniques,lap...AIM: Laparoscopic surgery, especially laparoscopic rectal surgery, for colorectal cancer has been developed considerably. However, due to relatively complicated anatomy and high requirements for surgery techniques,laparoscopic right colectomy develops relatively slowly. This study was designed to compare the outcomes of laparoscopic right hemicolectomy (LRH) with open right hemicolectomy (ORH) in the treatment of colon carcinoma.METHODS: Between September 2000 and February 2003,30 patients with colon cancer who underwent LRH were compared with 34 controls treated by ORH in the same period. All patients were evaluated with respect to surgeryrelated complications, postoperative recovery, recurrence and metastasis rate, cost-effectiveness and survival.RESULTS: Among 30 LRH, 2 (6.7%) were converted to open procedure. No significant differences were observed in terms of mean operation time, blood loss, post-operative complications, and hospital cost between LRH and ORH groups. Mean time for bowel movement, hospital stay,and time to resume early activity in the LRH group were significantly shorter than those in the ORH group (2.24±0.56vs 3.25±1.29 d, 13.94±6.5 vs 18.25±5.96 d, 3.94±1.64 vs 5.45±1.82 d respectively, P＜0.05). As to the lymph node yield, the specimen length and total cost for operation and drugs, there was no significant difference between the two groups. Local recurrence rate and metachronous metastasis rate had no marked difference between the two groups.Cumulative survival probability at 40 mo in LRH group (76.50%) was not obviously different compared to the ORH group (74.04%).CONCLUSION: LRH in patients with colon cancer has statistically and clinically significant advantages over ORH.Thus, LRH can be regarded as a safe and effective procedure.展开更多
目的:比较分析腹腔镜辅助下右半结肠癌根治术与开放手术的临床效果,探讨前者的安全性及有效性。方法:回顾性分析我科2009年12月至2013年12月共46例腹腔镜辅助下右半结肠癌根治术与同期68例开放右半结肠癌根治术患者临床病理资料,同时比...目的:比较分析腹腔镜辅助下右半结肠癌根治术与开放手术的临床效果,探讨前者的安全性及有效性。方法:回顾性分析我科2009年12月至2013年12月共46例腹腔镜辅助下右半结肠癌根治术与同期68例开放右半结肠癌根治术患者临床病理资料,同时比较两组的术后住院时间、手术时间、术中出血量、清扫淋巴结数、手术费用、排气时间、术后并发症及生存率情况。结果:术前资料性别、年龄、BMI、病理分型和浸润深度及术后清扫淋巴结总数等临床资料分析显示,两组差异无统计学意义。腹腔镜组术后住院时间6.84 d,而开放组为11.72 d,差异具有统计学意义,两组患者手术时间、住院费用相比,差异无统计学意义,腔镜组术中出血量76.63 m L,而开放组为141.5 m L,两组差异具有统计学意义。两组患者术后排气时间比较,差异有统计学意义。结论:腹腔镜辅助右半结肠癌根治术治疗结肠癌安全有效,具有创伤小、术后恢复快、手术切口美观等优点。展开更多
目的探讨达芬奇机器人与腹腔镜手术在右半结肠切除术中的安全性及有效性。方法检索Embase、Medline、Web of Science、中国知网及万方等数据库中2009年12月至今发表的有关右半结肠切除术的相关文献,使用Jadad评分及NOS评分评价文献质量...目的探讨达芬奇机器人与腹腔镜手术在右半结肠切除术中的安全性及有效性。方法检索Embase、Medline、Web of Science、中国知网及万方等数据库中2009年12月至今发表的有关右半结肠切除术的相关文献,使用Jadad评分及NOS评分评价文献质量,并使用Revman(5.3版)软件进行Meta分析。结果经过筛选纳入21篇文献,共计样本11648例,其中机器人组1523例,腹腔镜组10125例。Meta分析显示:在手术相关指标上,机器人组相比腹腔镜组手术时间更长[WMD=40.37,95%CI(28.88,51.86),P<0.01],但淋巴结清扫数更多[WMD=2.01,95%CI(0.59,3.44),P<0.01],中转开腹率更低[OR=0.31,95%CI(0.11,0.86),P=0.02],二者术中出血量无显著差异。在围手术期相关指标上,机器人组住院时间更短[WMD=-0.80,95%CI(-1.21,-0.39),P<0.01],肠道恢复更快[WMD=-0.43,95%CI(-0.70,-0.15),P<0.01],但费用比腹腔镜组显著提高。二者术后死亡率及并发症发生率差异无统计学意义。但机器人组伤口感染率[OR=0.66,95%CI(0.45,0.97),P=0.03]及吻合口瘘发生率[OR=0.37,95%CI(0.19,0.71),P<0.01]更低。结论达芬奇机器人行右半结肠切除术尽管手术时间较长,但术后恢复更快,淋巴清扫更彻底,伤口感染及吻合口瘘发生率更低。术后生活质量及预后资料较少,仍需开展高质量、大样本、多中心随机对照研究进行评价。展开更多
基金Supported by Science and Technology Development Foundation of Shanghai,No. 024119106
文摘AIM: Laparoscopic surgery, especially laparoscopic rectal surgery, for colorectal cancer has been developed considerably. However, due to relatively complicated anatomy and high requirements for surgery techniques,laparoscopic right colectomy develops relatively slowly. This study was designed to compare the outcomes of laparoscopic right hemicolectomy (LRH) with open right hemicolectomy (ORH) in the treatment of colon carcinoma.METHODS: Between September 2000 and February 2003,30 patients with colon cancer who underwent LRH were compared with 34 controls treated by ORH in the same period. All patients were evaluated with respect to surgeryrelated complications, postoperative recovery, recurrence and metastasis rate, cost-effectiveness and survival.RESULTS: Among 30 LRH, 2 (6.7%) were converted to open procedure. No significant differences were observed in terms of mean operation time, blood loss, post-operative complications, and hospital cost between LRH and ORH groups. Mean time for bowel movement, hospital stay,and time to resume early activity in the LRH group were significantly shorter than those in the ORH group (2.24±0.56vs 3.25±1.29 d, 13.94±6.5 vs 18.25±5.96 d, 3.94±1.64 vs 5.45±1.82 d respectively, P＜0.05). As to the lymph node yield, the specimen length and total cost for operation and drugs, there was no significant difference between the two groups. Local recurrence rate and metachronous metastasis rate had no marked difference between the two groups.Cumulative survival probability at 40 mo in LRH group (76.50%) was not obviously different compared to the ORH group (74.04%).CONCLUSION: LRH in patients with colon cancer has statistically and clinically significant advantages over ORH.Thus, LRH can be regarded as a safe and effective procedure.
文摘目的:比较分析腹腔镜辅助下右半结肠癌根治术与开放手术的临床效果,探讨前者的安全性及有效性。方法:回顾性分析我科2009年12月至2013年12月共46例腹腔镜辅助下右半结肠癌根治术与同期68例开放右半结肠癌根治术患者临床病理资料,同时比较两组的术后住院时间、手术时间、术中出血量、清扫淋巴结数、手术费用、排气时间、术后并发症及生存率情况。结果:术前资料性别、年龄、BMI、病理分型和浸润深度及术后清扫淋巴结总数等临床资料分析显示,两组差异无统计学意义。腹腔镜组术后住院时间6.84 d,而开放组为11.72 d,差异具有统计学意义,两组患者手术时间、住院费用相比,差异无统计学意义,腔镜组术中出血量76.63 m L,而开放组为141.5 m L,两组差异具有统计学意义。两组患者术后排气时间比较,差异有统计学意义。结论:腹腔镜辅助右半结肠癌根治术治疗结肠癌安全有效,具有创伤小、术后恢复快、手术切口美观等优点。
文摘目的探讨达芬奇机器人与腹腔镜手术在右半结肠切除术中的安全性及有效性。方法检索Embase、Medline、Web of Science、中国知网及万方等数据库中2009年12月至今发表的有关右半结肠切除术的相关文献,使用Jadad评分及NOS评分评价文献质量,并使用Revman(5.3版)软件进行Meta分析。结果经过筛选纳入21篇文献,共计样本11648例,其中机器人组1523例,腹腔镜组10125例。Meta分析显示:在手术相关指标上,机器人组相比腹腔镜组手术时间更长[WMD=40.37,95%CI(28.88,51.86),P<0.01],但淋巴结清扫数更多[WMD=2.01,95%CI(0.59,3.44),P<0.01],中转开腹率更低[OR=0.31,95%CI(0.11,0.86),P=0.02],二者术中出血量无显著差异。在围手术期相关指标上,机器人组住院时间更短[WMD=-0.80,95%CI(-1.21,-0.39),P<0.01],肠道恢复更快[WMD=-0.43,95%CI(-0.70,-0.15),P<0.01],但费用比腹腔镜组显著提高。二者术后死亡率及并发症发生率差异无统计学意义。但机器人组伤口感染率[OR=0.66,95%CI(0.45,0.97),P=0.03]及吻合口瘘发生率[OR=0.37,95%CI(0.19,0.71),P<0.01]更低。结论达芬奇机器人行右半结肠切除术尽管手术时间较长,但术后恢复更快,淋巴清扫更彻底,伤口感染及吻合口瘘发生率更低。术后生活质量及预后资料较少,仍需开展高质量、大样本、多中心随机对照研究进行评价。
