PDF(Pubmed)
Abstract：
UNASSIGNED: Traditional right hemicolectomy (TRH) is the standard treatment for patients with nonmetastatic right colon cancer. However, the ileocecum, a vital organ with mechanical and immune functions, is removed in these patients regardless of the tumor location. This study aimed to evaluate the technical and oncological safety of laparoscopic ileocecal-sparing right hemicolectomy (LISH).
UNASSIGNED: Patients who underwent LISH at two tertiary medical centers were matched 1:2 with patients who underwent TRH by propensity score matching based on sex, age, body mass index, tumor location, and disease stage. Data on surgical and perioperative outcomes were collected. Oncological safety was evaluated in a specimen-oriented manner. Lymph nodes (LNs) near the ileocolic artery (ICA) were examined independently in the LISH group. Disease outcomes were recorded for patients who completed one year of follow-up.
UNASSIGNED: In all, 34 patients in the LISH group and 68 patients in the TRH group were matched. LISH added 8 minutes to the dissection of LNs around the ileocolic vessels (groups 201/201d, 202, and 203 LNs), without affecting the total operation time, blood loss, or perioperative adverse event rate. Compared with TRH, LISH had a comparable lymphadenectomy quality, specimen quality, and safety margin while preserving a more functional bowel. The LISH group had no cases of LN metastasis near the ICA. No difference was detected in the recurrence rate at the 1-year follow-up time point between the two groups.
UNASSIGNED: In this dual-center study, LISH presented comparable surgical and oncological safety for patients with hepatic flexure or proximal transverse colon cancer.
UNASSIGNED: Patients who underwent LISH at two tertiary medical centers were matched 1:2 with patients who underwent TRH by propensity score matching based on sex, age, body mass index, tumor location, and disease stage. Data on surgical and perioperative outcomes were collected. Oncological safety was evaluated in a specimen-oriented manner. Lymph nodes (LNs) near the ileocolic artery (ICA) were examined independently in the LISH group. Disease outcomes were recorded for patients who completed one year of follow-up.
UNASSIGNED: In all, 34 patients in the LISH group and 68 patients in the TRH group were matched. LISH added 8 minutes to the dissection of LNs around the ileocolic vessels (groups 201/201d, 202, and 203 LNs), without affecting the total operation time, blood loss, or perioperative adverse event rate. Compared with TRH, LISH had a comparable lymphadenectomy quality, specimen quality, and safety margin while preserving a more functional bowel. The LISH group had no cases of LN metastasis near the ICA. No difference was detected in the recurrence rate at the 1-year follow-up time point between the two groups.
UNASSIGNED: In this dual-center study, LISH presented comparable surgical and oncological safety for patients with hepatic flexure or proximal transverse colon cancer.
摘要：
■传统右半结肠切除术（TRH）是非转移性右半结肠癌患者的标准治疗方法。然而,回盲肠,具有机械和免疫功能的重要器官，无论肿瘤位置如何，这些患者都被切除。本研究旨在评估腹腔镜保留回盲肠的右半结肠切除术（LISH）的技术和肿瘤安全性。
■在两个三级医疗中心接受LISH的患者与接受TRH的患者通过基于性别的倾向评分匹配进行1：2匹配，年龄,身体质量指数,肿瘤位置,疾病阶段。收集有关手术和围手术期结果的数据。以样本为导向的方式评估肿瘤安全性。在LISH组中，独立检查了回肠动脉（ICA）附近的淋巴结（LN）。记录完成一年随访的患者的疾病结果。
■总之，LISH组34例患者与TRH组68例患者相匹配。LISH在回肠血管周围LN的解剖中增加了8分钟（第201/201d组，202和203LN)，在不影响总操作时间的情况下，失血,或围手术期不良事件发生率。与TRH相比,LISH的淋巴结清扫质量相当，试样质量,和安全边缘，同时保留更有功能的肠道。LISH组ICA附近无LN转移病例。两组在1年随访时间点的复发率无差异。
■在这项双中心研究中，LISH对于肝曲或近端横结肠癌患者具有相当的手术和肿瘤学安全性。
■在两个三级医疗中心接受LISH的患者与接受TRH的患者通过基于性别的倾向评分匹配进行1：2匹配，年龄,身体质量指数,肿瘤位置,疾病阶段。收集有关手术和围手术期结果的数据。以样本为导向的方式评估肿瘤安全性。在LISH组中，独立检查了回肠动脉（ICA）附近的淋巴结（LN）。记录完成一年随访的患者的疾病结果。
■总之，LISH组34例患者与TRH组68例患者相匹配。LISH在回肠血管周围LN的解剖中增加了8分钟（第201/201d组，202和203LN)，在不影响总操作时间的情况下，失血,或围手术期不良事件发生率。与TRH相比,LISH的淋巴结清扫质量相当，试样质量,和安全边缘，同时保留更有功能的肠道。LISH组ICA附近无LN转移病例。两组在1年随访时间点的复发率无差异。
■在这项双中心研究中，LISH对于肝曲或近端横结肠癌患者具有相当的手术和肿瘤学安全性。
