Long-term oncologic outcomes of laparoscopic versus open resection following stent insertion for obstructing colon cancer: a multi-center retrospective study

被引:18
作者
Bae, Sung Uk [1 ,2 ,3 ]
Yang, Chun-Seok [4 ]
Kim, Sohyun [5 ]
Lim, Dae Ro [6 ]
Jeong, Woon Kyung [1 ,2 ]
Kim, Dae Dong [4 ]
Kim, Jae Hwang [5 ]
Shin, Eung Jin [6 ]
Lee, Yoo Jin [7 ]
Lee, Ju Yup [7 ]
Kim, Nam Kyu [3 ]
Baek, Seong Kyu [1 ,2 ]
机构
[1] Keimyung Univ, Sch Med, Dept Surg, 194 Dongsan Dong, Daegu 700712, South Korea
[2] Dongsan Med Ctr, 194 Dongsan Dong, Daegu 700712, South Korea
[3] Yonsei Univ, Coll Med, Severance Hosp, Div Colorectal Surg,Dept Surg,Colorectal Canc Cli, Seoul, South Korea
[4] Catholic Univ Daegu, Sch Med, Dept Colorectal Surg, Gyongsan, South Korea
[5] Yeungnam Univ, Dept Colorectal Surg, Coll Med, Gyongsan, South Korea
[6] Soonchunhyang Univ, Coll Med, Bucheon Hosp, Sect Colon & Rectal Surg,Dept Surg, Bucheon, South Korea
[7] Keimyung Univ, Sch Med, Dept Internal Med, Div Gastroenterol & Hepatol, Daegu, South Korea
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2019年 / 33卷 / 12期
基金
新加坡国家研究基金会;
关键词
Colonic neoplasm; Stent; Laparoscopy; Outcome; OXALIPLATIN; SURVIVAL; SAFETY;
D O I
10.1007/s00464-019-06680-7
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background This study compared oncologic outcomes between open and laparoscopic surgery following self-expanding metallic stents insertion for obstructing colon cancer. Methods This retrospective study included 50 patients who underwent open surgery and 44 patients who underwent laparoscopic surgery for obstructing left-sided colon cancer at four tertiary referral hospitals between June 2005 and December 2013. Results The median follow-up periods were 48 months and 47 months in the open and laparoscopic groups, respectively. The median operative time, time to soft diet, and length of stay were comparable between the groups. Four cases converted to open surgery (9.1%) in the laparoscopic group. The morbidity within 30 days after surgery was comparable between the groups (OR 0.931; 95% CI 0.357-2.426; p = 0.884). The proximal and distal resection margins, the histologic grade of tumor, TNM stage, median tumor size, and presence of lymphovascular invasion did not differ significantly between the groups. The 5-year overall survival (OS) rates of the open and laparoscopic groups were 67.1% and 71.7% (HR 1.028, 95% CI 0.491-2.15, p = 0.942) and the 5-year disease-free survival (DFS) rates were 55.8% and 61.5% (HR 0.982; 95% CI 0.522-1.847; p = 0.955), respectively. The recurrence pattern did not differ between the groups. Multivariate analysis showed that sex (p = 0.027), nodal stage (p = 0.043), and the proportion of patients receiving postoperative adjuvant chemotherapy (p = 0.002) were independent prognostic factors for OS. The proportion of patients receiving postoperative adjuvant chemotherapy (p = 0.017) was an independent prognostic factor for DFS. Conclusions Laparoscopic resection following stent insertion for obstructing colon cancer can be performed safely, with long-term oncologic outcomes comparable with those of open surgery.
引用
收藏
页码:3937 / 3944
页数:8
相关论文
共 13 条
  • [1] Improved Overall Survival With Oxaliplatin, Fluorouracil, and Leucovorin As Adjuvant Treatment in Stage II or III Colon Cancer in the MOSAIC Trial
    Andre, Thierry
    Boni, Corrado
    Navarro, Matilde
    Tabernero, Josep
    Hickish, Tamas
    Topham, Clare
    Bonetti, Andrea
    Clingan, Philip
    Bridgewater, John
    Rivera, Fernando
    de Gramont, Aimery
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (19) : 3109 - 3116
  • [2] MALIGNANT OBSTRUCTION OF THE LEFT COLON
    DEANS, GT
    KRUKOWSKI, ZH
    IRWIN, ST
    [J]. BRITISH JOURNAL OF SURGERY, 1994, 81 (09) : 1270 - 1276
  • [3] Dohmoto M., 1991, ENDOSCOPICA DIGESTIV, V3, P1507
  • [4] Laparoscopic colectomy for cancer: Improved compliance with guidelines for chemotherapy and survival
    Kim, Roger H.
    Kavanaugh, Mindie M.
    Caldito, Gloria C.
    [J]. SURGERY, 2017, 161 (06) : 1633 - 1641
  • [5] Tumour cell dissemination following endoscopic stent insertion
    Marudiachalam, K.
    Lash, G. E.
    Shenton, B. K.
    Horgan, A. F.
    [J]. BRITISH JOURNAL OF SURGERY, 2007, 94 (09) : 1151 - 1154
  • [6] Comparison of Long-Term Outcomes of Colonic Stent as "Bridge to Surgery" and Emergency Surgery for Malignant Large-Bowel Obstruction: A Meta-Analysis
    Matsuda, Akihisa
    Miyashita, Masao
    Matsumoto, Satoshi
    Matsutani, Takeshi
    Sakurazawa, Nobuyuki
    Takahashi, Goro
    Kishi, Taro
    Uchida, Eiji
    [J]. ANNALS OF SURGICAL ONCOLOGY, 2015, 22 (02) : 497 - 504
  • [7] MALIGNANT LARGE BOWEL OBSTRUCTION
    PHILLIPS, RKS
    HITTINGER, R
    FRY, JS
    FIELDING, LP
    [J]. BRITISH JOURNAL OF SURGERY, 1985, 72 (04) : 296 - 302
  • [8] Surgical management of obstructed colonic cancer
    Rault, A
    Collet, D
    Cunha, AS
    Larroude, D
    Ndobo'Epoy, F
    Masson, B
    [J]. ANNALES DE CHIRURGIE, 2005, 130 (05): : 331 - 335
  • [9] Feasibility and safety of laparoscopic resection following stent insertion for obstructing left-sided colon cancer
    Rho, Seoung Yoon
    Bae, Sung Uk
    Baek, Se Jin
    Hur, Hyuk
    Min, Byung Soh
    Baik, Seung Hyuk
    Lee, Kang Young
    Kim, Nam Kyu
    [J]. JOURNAL OF THE KOREAN SURGICAL SOCIETY, 2013, 85 (06): : 290 - 295
  • [10] OBSTRUCTING CARCINOMAS OF THE COLON
    SERPELL, JW
    MCDERMOTT, FT
    KATRIVESSIS, H
    HUGHES, ESR
    [J]. BRITISH JOURNAL OF SURGERY, 1989, 76 (09) : 965 - 969