大腸癌に対する腹腔鏡補助下大腸切除術―開腹移行の術後経過に対する影響―

Consequences of conversion from laparoscopy-assisted surgery to laparotomy for patients with colorectal cancer

◆要旨：腹腔鏡補助下大腸手術開腹移行症例の術後経過に対する影響を検討した．対象および方法：2002～2005年までに施行した開腹移行症例（Con群：n＝11）と，腹腔鏡下手術完遂症例（Lap群：n＝264），開腹手術症例（Open群：n＝221）の術後合併症，術後在院日数について比較検討した．結果：Con群の術後合併症発生率は，Lap群と比較して有意に高かったが，Open群とは有意差を認めなかった．Con群は術後平均在院日数がLap群より2.9日延長し有意に長かったが，Open群との間に有意差は認めなかった．結論：開腹移行により術後回復は遅れたが，開腹術に比べ遜色なかった．

　Purpose : The purpose of this study is to evaluate and compare the outcomes of patients whose laparoscopy-assisted surgery was converted to laparotomy, with those undergoing laparoscopic and open colorectal resections. Methodology : We reviewed 496 patients with consecutive colorectal resections performed between 2002 and 2005. Patients were divided into 3 groups according to the surgical procedures : conversions from laparoscopy-assisted surgery to laparotomy（Con : n＝11）, laparoscopic colorectal resections（Lap : n＝264）, and open colorectal resections（Open : n＝221）. Operative outcomes were compared between Con and the other 2 groups. Results : Con group was associated with significantly more morbidity than Lap group but no significant difference was observed with Open group. Con group was associated with longer hospital stay（2.9 days）compared to Lap group but there were also no significant difference between Open group. Conclusions : Conversion from laparoscopy-assisted surgery to open colorectal resection does not result in worse outcomes than open colorectal resections.