肠癌是一个重要的全球健康问题,位居全球第三的癌症。腹腔镜切除已成为可切除的结直肠癌的标准治疗方式。本研究旨在比较腹腔镜结直肠癌切除术中内侧至外侧(ML)与外侧至内侧(LM)方法的临床和肿瘤结果。
■2015年至2019年在英国地区综合医院进行了一项回顾性队列研究,包括402名符合特定标准的患者。人口统计,临床,Operative,术后,并收集肿瘤数据。参与者被分为LM和ML组。主要结果是30天并发症,次要结果包括手术持续时间,逗留时间,淋巴结收获,和3年生存率。
■共纳入402例患者(55.7%男性):外侧动员(LM)组102例(51.6%女性),内侧动员(ML)组280例(58.9%男性)。右半结肠切除术(n=157,39.1%)和前切除术(n=150,37.3%)是执行最多的手术。LM组右半结肠切除术的手术时间较短(中位数165vs.225分钟,P<0.001)和前切除术(中位数230vs.300分钟,P<0.001)。两组在伤口感染方面差异无统计学意义(P=0.443)。吻合口漏(P=0.981),术后肠梗阻(P=0.596),住院时间(P=0.446),淋巴结产量(P=0.848)或3年总生存率(Log-rank0.759)。
■该研究为ML与LM方法的有限证据做出了贡献。在这项研究中,LM组的手术时间较短,与一些文学相反。术后结果具有可比性,LM组术后肠梗阻无显著增加。该研究强调了两种方法的安全性和可行性。
UNASSIGNED: Bowel cancer is a significant global health concern, ranking as the third most prevalent cancer worldwide. Laparoscopic resections have become a standard treatment modality for resectable colorectal cancer. This study aimed to compare the clinical and oncological outcomes of medial to lateral (ML) vs lateral to medial (LM) approaches in laparoscopic colorectal cancer resections.
UNASSIGNED: A retrospective cohort study was conducted at a UK district general hospital from 2015 to 2019, including 402 patients meeting specific criteria. Demographic, clinical, operative, postoperative, and oncological data were collected. Participants were categorised into LM and ML groups. The primary outcome was 30-day complications, and secondary outcomes included operative duration, length of stay, lymph node harvest, and 3-year survival.
UNASSIGNED: A total of 402 patients (55.7% males) were included: 102 (51.6% females) in the lateral mobilisation (LM) group and 280 (58.9% males) in the medial mobilisation (ML) group. Right hemicolectomy (n=157, 39.1%) and anterior resection (n=150, 37.3%) were the most performed procedures. The LM group had a shorter operative time for right hemicolectomy (median 165 vs. 225 min, P<0.001) and anterior resection (median 230 vs. 300 min, P<0.001). There was no significant difference between the two groups in terms of wound infection (P=0.443), anastomotic leak (P=0.981), postoperative ileus (P=0.596), length of stay (P=0.446), lymph node yield (P=0.848) or 3-year overall survival rate (Log-rank 0.759).
UNASSIGNED: The study contributes to the limited evidence on ML vs LM approaches. A shorter operative time in the LM group was noted in this study, contrary to some literature. Postoperative outcomes were comparable, with a non-significant increase in postoperative ileus in the LM group. The study emphasises the safety and feasibility of both approaches.