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Short- and long-term results of open vs laparoscopic multisegmental resection and anastomosis for synchronous colorectal cancer located in separate segments

引用

世界胃肠外科杂志:英文版(电子版) 2023年第9期15卷 1969-1977页

作者： Ji-Chuan Quan Xin-Jun Zhou Shi-Wen Mei Jun-Guang Liu Wen-Long Qiu Jin-Zhu Zhang Bo Li Yue-Gang Li Xi-Shan Wang Hu Chang Jian-Qiang Tang Department of Colorectal Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Colorectal Anorectal Surgery Shengli Oilfield Central HospitalDongying 257000Shandong ProvinceChina Department of General Surgery Peking University First HospitalBeijing 100034China Department of Hospital Administration Office National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND It remains unclear whether laparoscopic multisegmental resection and ana-stomosis(LMRA)is safe and advantageous over traditional open multisegmental resection and anastomosis(OMRA)for treating synchronous colorectal cancer(SCRC)located in separate *** To compare the short-term efficacy and long-term prognosis of OMRA as well as LMRA for SCRC located in separate *** Patients with SCRC who underwent surgery between January 2010 and December 2021 at the Cancer Hospital,Chinese Academy of Medical Sciences and the Peking University First Hospital were retrospectively *** accordance with the RESULTS LMRA patients showed markedly less intraoperative blood loss than OMRA patients(100 vs 200 mL,P=0.006).Compared to OMRA patients,LMRA patients exhibited markedly shorter postoperative first exhaust time(2 vs 3 d,P=0.001),postoperative first fluid intake time(3 vs 4 d,P=0.012),and postoperative hospital stay(9 vs 12 d,P=0.002).The incidence of total postoperative complications(Clavien-Dindo grade:≥II)was 2.9%and 17.1%(P=0.025)in the LMRA and OMRA groups,respectively,while the incidence of anastomotic leakage was 2.9%and 7.3%(P=0.558)in the LMRA and OMRA groups,***,the LMRA group had a higher mean number of lymph nodes dissected than the OMRA group(45.2 vs 37.3,P=0.020).The 5-year overall survival(OS)and disease-free survival(DFS)rates in OMRA patients were 82.9%and 78.3%,respectively,while these rates in LMRA patients were 78.2%and 72.8%,*** prognostic analysis revealed that N stage[OS:HR hazard ratio(HR)=10.161,P=0.026;DFS:HR=13.017,P=0.013],but not the surgical method(LMRA/OMRA)(OS:HR=0.834,P=0.749;DFS:HR=0.812,P=0.712),was the independent influencing factor in the OS and DFS of patients with *** LMRA is safe and feasible for patients with SCRC located in separate *** to OMRA,the LMRA approach has more advantages related to short-term efficacy.

关键词： Synchronous colorectal cancer separate segments Laparoscopic surgery Multisegmental resection Short-term efficacy Prognosis

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