Single-incision Laparoscopic Surgery Versus Conventional Laparoscopy for Colorectal Cancer: A Comparison of Oncologic Outcomes

於大腸直腸治療使用單孔腹腔鏡手術對上傳統腹腔鏡：惡性腫瘤預後之比較

王景賢(Ching-Hsien Wang) ； 林岳民(Yueh-Ming Lin) ； 陳鴻華(Hong-Hwa Chen) ； 張家駱(Chia-Lo Chang) ； 李克釗(Ko-Chao Lee) ； 蔡鎧隆(Kai-Lung Tsai) ； 盧建璋(Chien-Chang Lu)

《中華民國大腸直腸外科醫學會雜誌》 26卷4期 (2015/12) Pp. 142-149

https://doi.org/10.6312/SCRSTW.2015.26(4).10409

摘要

目的：在治療大腸直腸惡性腫瘤上，比較單孔腹腔鏡手術及傳統腹腔鏡手術這兩種方法的手術及惡性腫瘤預後。方法：我們審視介於西元2007年1月到西元2012年1月之間所有接受傳統腹腔鏡及單孔腹腔鏡手術的大腸直腸惡性腫瘤病人的病歷。此研究納入的條件包含第一期到第三期的大腸直腸腺癌。我們回溯地評估分析病患的統計特徵、手術及腫瘤預後。結果：我們納入161個病患，包括88個接受單孔腹腔鏡手術，73個接受傳統腹腔鏡手術。此兩組在年紀、性別、身高體重指數、麻醉危險分級並無統計學上差異。在手術的結果，除手術時間及改變手術術式以外，其他的結果都是相似的。接受單孔腹腔鏡手術的病患，有14個接受病患於術中增加了額外的套管，但沒有任何1個轉變術式為剖腹探查。接受傳統腹腔鏡手術的病患，有1個病患轉變術式為剖腹探查。在腫瘤預後方面，接受單孔腹腔鏡手術病患所被拿取的平均淋巴數目是較多的（p=0.033）。結論：和傳統腹腔鏡手術比較起來，使用單孔腹腔鏡手術治療大腸直腸惡性腫瘤在手術及惡性腫瘤相關的成效方面提供相同的效果。執行單孔腹腔鏡手術並沒有顯著地增加併發症或改變為剖腹探查等缺點，可考慮當成傳統腹腔鏡手術的另一種方案。

關鍵字

單一切口 ； 腹腔鏡 ； 惡性腫瘤相關成效 ； 大腸直腸癌

並列摘要

Purpose. To compare the perioperative and oncologic outcomes between conventional laparoscopy (CL) and single-incision laparoscopic surgery (SILS) for colorectal malignancy. Methods. The medical records of patients who underwent CL and SILS for the treatment of colorectal malignancy between January 2007 and January 2012 were reviewed. The inclusion criteria were stages 1-3 colorectal adenocarcinoma. The demographics, perioperative data, and oncologic outcomes were retrospectively evaluated. Results. We recruited 161 patients to participate. Eighty-eight patients underwent SILS and 73 underwent CL initially. The two groups did not differ significantly in terms of age, sex, body mass index (BMI), and the American Society of Anesthesiology (ASA) score. The intraoperative and perioperative outcomes were similar, except with regard to the operation time and conversion. Fourteen patients in the SILS group were converted to additional ports, but no conversion to laparotomy occurred in this group. One patient in the CL group was converted to laparotomy. Regarding the oncologic outcomes, the number of harvested lymph nodes in the SILS group was significantly more than that in the CL group (p=0.033). Conclusions. SILS for colorectal malignancy provided a nearly equivalent efficacy for the operative and oncologic outcomes in comparison to CL. No significant disadvantages such as complications and conversion to laparotomy were found after performing SILS. Thus, SILS may be considered as an alternative to CL.

並列關鍵字

Single incision ； Laparoscopy ； Oncologic outcome ； Colorectal cancer

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