Laparoscopic multivisceral resection for locally advanced colon cancer: a single-center analysis of short- and long-term outcomes

被引:9
作者
Mukai, Toshiki [1 ]
Nagasaki, Toshiya [1 ]
Akiyoshi, Takashi [1 ]
Fukunaga, Yosuke [1 ]
Yamaguchi, Tomohiro [1 ]
Konishi, Tsuyoshi [1 ]
Nagayama, Satoshi [1 ]
Ueno, Masashi [1 ]
机构
[1] Japanese Fdn Canc Res, Canc Inst Hosp, Dept Gastroenterol Surg, Koto Ku, 3-10-6 Ariake, Tokyo 1358550, Japan
关键词
Laparoscopic surgery; Multivisceral resection; Colon cancer; Survival; MRC CLASICC TRIAL; COLORECTAL-CANCER; OPEN SURGERY; OPEN COLECTOMY; CHEMOTHERAPY; MULTICENTER; CONVERSION; MORBIDITY; SURVIVAL; SAFETY;
D O I
10.1007/s00595-020-01986-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose We evaluated the technical and oncological safety of laparoscopic multivisceral resection (MVR) in selected patients with locally advanced colon cancer (LACC). Methods We compared the clinical backgrounds, and short- and long-term outcomes of patients who underwent laparoscopic vs. those who underwent open MVR for LACC en bloc at our hospital. Results Between January, 2004 and December, 2015, 140 patients underwent MVR of the primary tumor en bloc via laparoscopic surgery (laparoscopic group; LG, n = 69) or open surgery (open group; OG, n = 71). Laparoscopic surgery was selected mainly for tumors that invaded the bladder and abdominal wall. The LG patients had smaller tumors (60 vs. 80 mm, p < 0.001), less blood loss (30 vs. 181 g, p < 0.001), and shorter hospital stays (12 vs. 19 days, p < 0.001) than the OG patients. Open conversion was required for two patients. Postoperative complications and R0 resection were comparable between the groups. Local recurrence occurred in two LG patients and two OG patients. The 5-year cancer-specific survival, disease-free survival, and local disease-free survival of patients with pT4b disease were not significantly different between the LG and OG groups (90.3% vs. 75.2%, 71.2% vs. 67.6%, and 97.1% vs. 94.2%). Conclusion Although the LG included patients with lower risk, the short- and long-term outcomes were equivalent to those of the OG, which included patients with higher risk.
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页码:1024 / 1031
页数:8
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