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題名 | Single-incision Laparoscopic Surgery Using a Transumbilical Glove-port for Synchronous Colectomy and Hepatectomy: A Preliminary Experience in 9 Patients=利用經臍單孔腹腔鏡行同時性大腸癌合併肝臟腫瘤之切除手術:9位病例之原始報告 |
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作者姓名(中文) | 孫麒洹; 謝孟樵; 郭亮鉾; 陳君漢; 黃政義; 黃文詩; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 30:1 2019.03[民108.03] |
頁次 | 頁36-44 |
分類號 | 416.245 |
關鍵詞 | 單切口腹腔鏡手術; 大腸直腸癌合併肝轉移; 手術預後; Single-incision laparoscopic surgery; Synchronous colorectal and hepatic cancer; Surgical outcome; |
語文 | 英文(English) |
中文摘要 | 目的:本研究在分析利用單切口腹腔鏡手術作為大腸直腸癌合併肝轉移腫瘤切除之可行性及安全性。方法:自2011年5月至2013年9月,共有9位大腸直腸癌合併肝臟轉移之病患,利用腹腔鏡器械及自製多套筒系統而完成單切口腹腔鏡手術。病患的臨床資料、手術時間、廓清淋巴結數目、失血量、傷口大小、術後併發症及住院天數皆納入分析。結果:共收納9位病患。其中有4位(44.4%)接受術前輔助性治療,包括放射線治療(2位)及化學療法合併標靶治療(2位)。肝臟的病理結果則顯示有8位是轉移性肝腫瘤,一位是膽管癌。單切口腹腔鏡手術之平均傷口大小為4.1公分(2.0-5.8公分)。平均手術時間是339分鐘(165-595分鐘),其中大腸直腸癌手術部分平均為144分鐘(75-375分鐘),而肝臟腫瘤則為194分鐘(115-285分鐘)。術中皆無轉換成傳統開腹或多孔腹腔鏡手術。術後併發症為骨盆腔膿瘍,發生於一位曾接受術前放射線治療的直腸癌病人中。平均住院天數為7.6天(4-17天)。結論:在部分大腸直腸癌合併肝臟轉移的病患,使用腹腔鏡器械及自製多套筒系統作為單切口腹腔鏡大腸直腸及肝臟腫瘤同時切除手術是可行及安全的。 |
英文摘要 | Purpose. We evaluated the feasibility and safety of performing single-incision laparoscopic surgery (SILS) for synchronous colectomy and hepatectomy using straight laparoscopic instruments and a "home-made" multichannel port system. Methods. SILS was performed in 9 patients (6 men, 3 women) with colorectal adenocarcinoma (CRC) and concurrent liver tumors between May 2011 and September 2013. Demographic data, intraoperative parameters, and postoperative outcomes were evaluated. Results. Among 9 patients with CRC who underwent colectomy, 4 received neoadjuvant treatment (44.4%) - 2 received radiotherapy and 2 received chemotherapy with/without target therapy. The final histopathological examination revealed 8 metastasized liver tumors and 1 primary cholangiocarcinoma. SILS was performed via a mean incision length of 4.1 cm (range 2.0-5.8 cm) with a mean procedure time of 339 min (range 165-595 min). Mean operation time for the CRC and the liver tumors was 144 min (range 75-375 min.) vs. 194 min (range 115-285 min). No patient required conversion to laparotomy or supplementary trocar insertion. Pelvic abscess was observed in a patient with rectal cancer who had received preoperative radiotherapy. No perioperative mortality was reported. The overall mean hospital stay was 7.6 days (range 4-17 days). Conclusion. SILS is feasible and safe in specific group of patients with synchronous colorectal malignancy and hepatic tumors necessitating colectomy concurrent with hepatectomy using straight laparoscopic instruments and a "home-made" port. |
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