Short-term Surgical Result and Oncological Follow up of Laparoscopic Anterior Resection for Malignant Disease

腹腔鏡前位切除術治療惡性疾病之短期手術成果及追蹤

陳明正(Ming-Cheng Chen) ； 蔣鋒帆(Feng-Fan Chiang) ； 王輝明(Hwei-Ming Wang) ； 趙德馨(De-Xing Chao) ； 馬秀峰(Hsiu-Feng Ma)

《中華民國大腸直腸外科醫學會雜誌》 21卷2期 (2010/06) Pp. 69-78

https://doi.org/10.6312/SCRSTW.2010.21(2).09827

摘要

Background. Laparoscopic anterior resection has been recognized as a safe and effective alternative to conventional anterior resection, but the experience sharing is rare in Taiwan.
Methods. This was a single-surgical team, single-center retrospective study. From 1998 to 2006 all patients admitted via our out-patient department for elective anterior resection of proved colorectal malignancy were evaluated for eligibility. Cases of emergent operation and obvious sign of bowel obstruction were excluded.
Results. Laparoscopic anterior resection was associated with shorter hospital stay (10.3d vs. 15d, p＜0.001), with higher hospital fee ($121112 vs. $106721, p＜0.0001), lower wound complication rate (0% vs. 11%, p＜0.0001), and longer operation time (180.8 minutes vs.140 minutes, p＜0.0001) compared with conventional anterior resection. Increased incidence of liver metastasis was found in laparoscopy group while overall survival was not affected.
Conclusion. Laparoscopic anterior resection is a safe alternative to conventional anterior resection for colorectal malignancy in Taiwanese patients. The increased incidence of liver metastasis in laparoscopy group deserved further investigation and may be casused by pneumoperitoneum. The operation time and hospital fee were longer and higher for laparoscopy surgeries.

關鍵字

腹腔鏡 ； 前位切除 ； 大腸直腸癌

並列摘要

Background. Laparoscopic anterior resection has been recognized as a safe and effective alternative to conventional anterior resection, but the experience sharing is rare in Taiwan.
Methods. This was a single-surgical team, single-center retrospective study. From 1998 to 2006 all patients admitted via our out-patient department for elective anterior resection of proved colorectal malignancy were evaluated for eligibility. Cases of emergent operation and obvious sign of bowel obstruction were excluded.
Results. Laparoscopic anterior resection was associated with shorter hospital stay (10.3d vs. 15d, p＜0.001), with higher hospital fee ($121112 vs. $106721, p＜0.0001), lower wound complication rate (0% vs. 11%, p＜0.0001), and longer operation time (180.8 minutes vs.140 minutes, p＜0.0001) compared with conventional anterior resection. Increased incidence of liver metastasis was found in laparoscopy group while overall survival was not affected.
Conclusion. Laparoscopic anterior resection is a safe alternative to conventional anterior resection for colorectal malignancy in Taiwanese patients. The increased incidence of liver metastasis in laparoscopy group deserved further investigation and may be casused by pneumoperitoneum. The operation time and hospital fee were longer and higher for laparoscopy surgeries.

並列關鍵字

Laparoscopy ； Anterior resection ； Colorectal cancer