A comparative study of total laparoscopic and laparoscopic-assisted simultaneous resection for colorectal cancer liver metastasis
10.3760/cma.j.cn112152-112152-20190814-00526
- VernacularTitle:结直肠癌肝转移全腹腔镜与腹腔镜辅助同期切除术的比较研究
- Author:
Xingchen LI
1
;
Zhiyu LI
;
Zhiwen LUO
;
Xinyu BI
;
Jianqiang CAI
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院肝胆外科 100021
- Keywords:
Colorectal neoplasms;
Liver metastasis;
Simultaneous surgery;
Propensity score matching;
Laparoscopy
- From:
Chinese Journal of Oncology
2020;42(5):413-418
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the safety and outcome between total laparoscopic and laparoscopy-assisted synchronous resection for colorectal cancer patients with liver metastases.Methods:The data of patients who underwent total laparoscopic or laparoscopy-assisted simultaneous resection of primary colorectal cancer and liver metastases in our hospital between December 2008 and December 2016 were collected and analyzed. The total laparoscopic surgery patients were matched 1∶2 to the laparoscopy-assisted surgery patients based on the propensity score. 22 patients were classified in the total laparoscopic group and 44 patients were classified in the laparoscopy-assisted group. The intraoperative conditions and postoperative outcomes of the two groups were compared.Results:There was no difference in the preoperative baseline data between the two groups ( P>0.05). The median operative time were 317.50 and 267.50 minutes in the total laparoscopic group and the laparoscopy-assisted group, respectively, and the median intraoperative blood loss were 100 and 200 ml, both with no statistically significant differences ( P>0.05). There were 1 case of intraoperative blood transfusion in the total laparoscopic group and 5 cases in the laparoscopy-assisted group, with no statistically significant difference ( P=0.650). The median postoperative hospital stay in the two groups were 11.0 and 10.0 days, the median postoperative defecation time were 4.0 and 4.0 days and postoperative complication rates were 13.6% and 20.5%, and none of these differences were statistically significant ( P>0.05). However, no Clavien-DindoⅡ level and above complications occurred in total laparoscopic group. The median disease-free survival (DFS) were 15.0 and 15.7 months in the total laparoscopic group and the laparoscopy-assisted group, the overall survival (OS) were 25.9 and 37.6 months, respectively, with no statistically significant differences ( P>0.05). Conclusion:Laparoscopy-assisted approaches are similar, so the appropriate approach should be chosen according to the clinical condition and surgeon′s experience.
