Background: Additional surgery is necessary in cases with non-curative endoscopic submucosal dissection. It is still unknown whether preceding endoscopic submucosal dissection (ESD) for T1 colorectal carcinoma affects the short outcomes of patients who underwent additional surgery or not as compared with surgery alone without ESD. Methods: Patients (101 pairs) with T1 colorectal cancer who underwent additional laparoscopic-assisted surgery after endoscopic submucosal dissection (additional surgery group, n = 101) or laparoscopic-assisted surgery alone (surgery alone group, n = 101) were matched (1:1). Short-term morbidity, operation outcomes, and lymph node metastasis of the resected specimen were compared. Results: There were no significant differences between the additional laparoscopic-assisted surgery and laparoscopic-assisted surgery alone groups in lymph node metastasis (9.9 vs. 5.9%, respectively, p = 0.297), operative time (147.76 ± 52.00 min vs. 156.50 ± 54.28 min, p = 0.205), first flatus time (3.56 ± 1.10 days vs. 3.63 ± 1.05 days, p = 0.282), first stool time (4.30 ± 1.04 days vs. 4.39 ± 1.22 days, p = 0.293), time to intake (5.00 ± 1.18 days vs. 5.25 ± 1.39 days, p = 0.079), blood loss (44.75 ± 45.40 mL vs. 60.40 ± 78.98 mL, p = 0.603), harvest lymph nodes (18.74 ± 7.22 vs. 20.32 ± 9.69, p = 0.438), postoperative surgical complications (p = 0.733), and postoperative length of hospital stay (8.68 ± 4.00 days vs. 8.39 ± 1.94 days, p = 0.401). Conclusion: ESD did not increase the difficulty of additional laparoscopic-assisted surgery, hospital stay, or the incidence of postoperative complications. Additional laparoscopic-assisted surgery is safe and recommended for patients with T1 cancer at high risk of lymph node metastasis and residual cancer after non-curative ESD.
Dig Surg

中文翻译：

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内窥镜黏膜下剥离术后额外的腹腔镜辅助手术是否会影响 T1 期结直肠癌患者的短期预后？基于倾向得分的分析

背景：对于非治愈性内窥镜黏膜下剥离术的病例，需要进行额外的手术。与不接受 ESD 的单独手术相比，对于 T1 结直肠癌进行内镜黏膜下剥离术 (ESD) 是否会影响接受额外手术的患者的短期预后尚不清楚。方法：患者（101对）与T1结肠直肠癌谁内窥镜黏膜下层剥离术后行附加腹腔镜辅助的外科手术（附加手术组， Ñ = 101）或腹腔镜辅助单纯手术（单纯手术组， Ñ = 101）进行匹配（1 :1)。比较了切除标本的短期发病率、手术结果和淋巴结转移。结果：在淋巴结转移（分别为 9.9% vs. 5.9%，p = 0.297）、手术时间（147.76 ± 52.00 min vs. 156.50 ± 54.28 min）方面，额外腹腔镜辅助手术组和单独腹腔镜辅助手术组之间没有显着差异, p = 0.205), 第一次排气时间 (3.56 ± 1.10 天 vs. 3.63 ± 1.05 天, p = 0.282), 第一次大便时间 (4.30 ± 1.04 天 vs. 4.39 ± 1.22 天, p = 0.293), 摄入时间 (0.293) 5.00±1.18天对比5.25±1.39天，p = 0.079），失血（44.75±45.40 mL相对60.40±78.98毫升，p = 0.603），收获淋巴结（18.74±7.22 20.32对比±9.69，p = 0.438), 术后手术并发症 ( p= 0.733）和术后住院时间（8.68 ± 4.00 天对 8.39 ± 1.94 天，p = 0.401）。结论： ESD并未增加额外腹腔镜辅助手术的难度、住院时间或术后并发症的发生率。额外的腹腔镜辅助手术是安全的，推荐用于非治愈性 ESD 后淋巴结转移和残留癌风险高的 T1 癌患者。
挖掘外科