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于庭 發問時間: 社會與文化語言 · 1 0 年前


Abstract Early experienceswith laparoscopic colectomywere unfavorable,withhigher than expected ratesof wound tumor implants and concerns about short and long-term compromised oncologicoutcomes. Several international randomized controlled trials were initiated to address concernsregarding compromised oncologic outcomes. Each of the trials was designed to test the hypothesisthat level 1evidence supports the general feasibility and recovery advantage as well ascancer equivalence of laparoscopic colectomy in curable colon cancer. The following four phaseIII randomized controlled trials have completed accrual and reported early data on recovery benefitsfor laparoscopic colectomy: Barcelona, Clinical Outcomes of Surgical Therapy Study Group(COSTSG), Colon Cancer Laparoscopic or Open Resection (COLOR), and Conventional versusLaparoscopic-Assisted Surgery in Colorectal Cancer (CLASICC).These trials have uniformly andconsistently shown a significant reduction in the use of narcotics and oral analgesics and lengthof hospital stay, aswell as a faster return of diet and bowel function,with laparoscopic colectomy.Two of the trials, Barcelona and COSTSG, have sufficient maturation and follow-up to reportrecurrence and survival data, and neither has found a survival disadvantage in patients treatedwith laparoscopic colectomy. Results of the Barcelona trial suggest a cancer-related survivaladvantage in patients treatedwith laparoscopic colectomy, based solely on differences inpatientswith stage III disease; this is not confirmed by the COSTSG trial. Results of the CLASICC andCOLOR trials, as well as 5-year data from the COSTSG trial, should definitively address survivalresults.



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  • 1 0 年前

    腹腔鏡檢查colostomy的抽象盡快經驗不利,帶有比期望的比率的傷口瘤種植高和關心窄和長期和解的腫瘤學在外來。國際隨機化排列控制的審訊被起動寄給的幾關係到關於在共同邏輯結果上和解。每次審訊被用於測試假說, 1evidence 水準在可治愈的結腸癌裡支援腹腔鏡檢查的colostomy的一般的可行性和回收優勢以及癌症相等。以下4 phaseIII隨機化排列控制的審訊完成增加並且報告在痊愈好處適合腹腔鏡檢查的colostomy上的盡快數據︰ 巴塞羅那,外科的治療學習旅遊團(COSTSG)的臨床的結果 ,結腸癌腹腔鏡檢查或者公開的交叉(顏色) ,並且在結腸直腸的癌症(CLASICC)裡道統與腹腔鏡檢查幫助的手術 . 這些審訊已經均勻並且一貫顯示在使用麻醉劑方面的明顯減少,醫院的口頭的止痛藥和長度停留, 以及飲食的更快的返回和腸功能,帶有腹腔鏡檢查的colostomy。 審訊中的兩,巴塞羅那和COSTSG,有足夠的成熟和後續行動報告重現和生存數據, 並且兩者都不都沒在病患的用裡處理的腹腔鏡檢查的colostomy找到一個生存不利條件。 巴塞羅那試驗的結果建議在用腹腔鏡檢查的colostomy處理的病患裡的一個有關癌症的生存優勢,隨著第III 階段疾病僅僅在差別住院病患基於; 這沒因為COSTSG 審訊被確認。 CLASICC 和顏色審訊,以及5年數據從COSTSG 審訊的結果,definitively 位址生存結果應該。

    參考資料: 有些字是不是打錯,有一些我不知道意思,很抱歉
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