腹腔镜手术治疗直肠癌术后转换对手术效果的影响——对1073例患者的回顾性分析

腹腔镜手术治疗直肠癌术后转换对手术效果的影响——对1073例患者的回顾性分析
Impact of Conversion on Surgical Outcomes after Laparoscopic Operation for Rectal Carcinoma- A Retrospective Study of 1,073 Patients

Abstract
BACKGROUND:
In laparoscopic operations for rectal carcinoma, only a few multicenter studies of a large number of patients have examined the impact of conversion on outcomes and determined risk factors for conversion. This study was designed to evaluate short-term outcomes and risk factors for conversion to open operation in laparoscopic operations for rectal carcinoma.
摘要
背景：
在腹腔镜直肠癌手术中，只有少数的多中心研究了大量的患者检查转换的结果和确定的风险因素的转换。本研究的目的是评估短期的结果和危险因素转换为开放手术在腹腔镜手术治疗直肠癌。

STUDY DESIGN:
A total of 1,073 patients with carcinoma of the rectum and anus who underwent laparoscopic operations were reviewed retrospectively. Patients were collected from 28 institutions. Patients who required conversion during laparoscopic operation were compared with those with completed laparoscopic resection.
研究设计：
对1073例行腹腔镜手术的直肠和肛门癌患者进行回顾性分析。患者被收集从28个机构。腹腔镜手术时需要转换的患者进行了比较与那些完成腹腔镜切除术。

RESULTS:
Conversion rate was 7.3% (n = 78), and patients requiring conversion were considerably heavier (mean body mass index 24.6 versus 22.7) and had a substantially higher rate of low anterior resection (94.9% versus 83.5%). Conversion was also associated with longer operation time (median 295 minutes versus 270 minutes), greater blood loss (median 265 mL versus 80 mL), longer median postoperative hospital stay (20 days versus 14 days), and higher rates of intraoperative (32.1% versus 3.5%) and postoperative (43.6% versus 21.1%) complications. In multivariate analysis, body mass index and rate of low anterior resection were predictive of conversion.
结果:
转换率为7.3%（n = 78），需要转换的患者是相当重的（平均体重指数24.6与22.7），有一个显着较高的低前切除率（94.9%比83.5%）。转换也具有手术时间较长（平均295分钟与270分钟），大出血（中位数为265毫升和80毫升），平均术后住院时间较长（20天与14天），与术中率更高（32.1%比3.5%）和术后（43.6%和21.1%）的并发症。在多因素分析中，身体质量指数和低前切除率是预测的转换。

CONCLUSIONS:
Conversion to open operation is associated with greater morbidity than completed laparoscopic resection. Body mass index and the particular laparoscopic procedure are risk factors for conversion, indicating that appropriate patient selection is essential in laparoscopic operations for rectal carcinoma.
结论：
开放手术的转换与更大的发病率比完成腹腔镜切除术。身体质量指数和特定的腹腔镜手术是转换的危险因素，表明适当的病人选择是必不可少的，在腹腔镜手术治疗直肠癌。

英文原文：
Impact of Conversion on Surgical Outcomes after Laparoscopic Operation for Recta.pdf (92.88 KB, 下载次数: 0, 售价: 99 香叶)

2016-10-18 13:29 上传

点击文件名下载附件
Impact of Conversion on Surgical Outcomes after Laparoscopic Operation for Rectal Carcinoma- A Retro ...