Y. Gevorkyan, V. E. Kolesnikov, N. Soldatkina, D. Kharagezov, A. Dashkov, D. Kaymakchi, E. Mirzoyan, S. I. Poluektov, R. E. Tolmakh, O. Stateshny, V. Doncov
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The study demonstrated that laparoscopy with a combination of developed surgical techniques significantly ( р <0.05) reduced the number of surgical complications in the main group (1.8%) compared to controls (12.8%). Patients with metastatic colorectal cancer receiving laparoscopy demonstrated higher, compared to patients with stan-dard open surgery, relative risks of cardiovascular and respiratory complications (HR=4.7, р =0.001), thrombohemor-rhagic complications (HR=2.8, р =0.05) and arrhythmia (HR=3.73, р =0.07), but lower risks of surgical complications (HR=0.13, р =0.001). Survival of patients with metastatic colorectal patients was statistically significantly higher in the main group compared to controls: log-rank test = 2.11 at р =0.035. Conclusions . Laparoscopy reduced the number of surgical complications, compared to open surgery. 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引用次数: 1
摘要
研究目的:目的:提高腹腔镜手术技术治疗转移性结直肠癌的效果。患者和方法。我们分析了311例44-78岁的结直肠癌和肝转移患者的数据;2005-2015年期间,所有患者都在俄罗斯卫生部国家肿瘤医学研究中心接受治疗。主要组包括161例接受腹腔镜手术的转移性结肠癌和可切除肝转移患者;对照组为150例接受开放性手术的相同疾病患者。结果。研究表明,与对照组(12.8%)相比,腹腔镜联合先进手术技术显著降低了主组(1.8%)手术并发症的发生率(p <0.05)。与标准开放手术患者相比,接受腹腔镜治疗的转移性结直肠癌患者心血管和呼吸系统并发症(HR=4.7, r =0.001)、血栓出血并发症(HR=2.8, r =0.05)和心律失常(HR=3.73, r =0.07)的相对风险更高,但手术并发症的风险较低(HR=0.13, r =0.001)。与对照组相比,主组转移性结直肠癌患者的生存率具有统计学意义:log-rank检验= 2.11,χ =0.035。结论。与开放手术相比,腹腔镜手术减少了手术并发症的数量。然而,有合并症的患者出现其他并发症的相对风险更高。
MINIMALLY INVASIVE SURGERY IN TREATMENT OF PATIENTS WITH METASTATIC COLORECTAL CANCER
Purpose of the study. Was to improve the results of treatment for metastatic colorectal cancer using laparoscopic surgical technologies. Patients and methods. We analyzed the data on 311 patients aged 44–78 years with colorectal cancer and liver metastases; in 2005–2015, all patients received treatment at National Medical Research Centre for Oncology of the Ministry of Health of Russia. The main group included 161 patients with metastatic colon cancer and resectable liver metastases receiving laparoscopic surgery; 150 patients with the same disease receiving open surgery were controls. Results . The study demonstrated that laparoscopy with a combination of developed surgical techniques significantly ( р <0.05) reduced the number of surgical complications in the main group (1.8%) compared to controls (12.8%). Patients with metastatic colorectal cancer receiving laparoscopy demonstrated higher, compared to patients with stan-dard open surgery, relative risks of cardiovascular and respiratory complications (HR=4.7, р =0.001), thrombohemor-rhagic complications (HR=2.8, р =0.05) and arrhythmia (HR=3.73, р =0.07), but lower risks of surgical complications (HR=0.13, р =0.001). Survival of patients with metastatic colorectal patients was statistically significantly higher in the main group compared to controls: log-rank test = 2.11 at р =0.035. Conclusions . Laparoscopy reduced the number of surgical complications, compared to open surgery. However, patients with comorbid pathologies showed higher relative risks of other complications.