摘要
目的探讨全结肠系膜切除术(CME)与传统根治术治疗Ⅲ期结肠癌的临床疗效与安全性。方法回顾性分析2011年6月至2015年6月收治的113例Ⅲ期结肠癌患者的临床资料,根据手术方式分为CME组(58例,行全结肠系膜切除术)和传统组(55例,行传统结肠癌根治术),采用SPSS17.0软件进行数据分析,两组术中术后相关指标采用(x珋±s)表示,采用独立t检验;术后并发症发生率、复发率及病死率等组间比较采用χ2检验,以P<0.05为差异有统计学意义。结果 CME组淋巴结清扫数目、术中出血量明显优于传统组(P<0.05);两组患者手术时间、远近切缘距肿瘤距离、术后首次通气时间、首次排便时间、下床活动时间、开始进食时间、平均住院时间以及术后并发症发生率比较差异均无统计学意义(均P>0.05);CME组患者术后2年内复发率明显低于传统组(5.2%比21.8%,χ2=6.795,P=0.009);CME组患者术后2年内病死率明显低于传统组(3.4%比12.7%,χ2=4.310,P=0.038)。结论全结肠系膜切除术治疗Ⅲ期结肠癌与传统结肠癌根治术疗效相当,具有淋巴结清扫更加彻底,手术出血量少,术后复发率低的优势。
Objective To investigate the clinical efficacy and safety of complete mesocolic excision （CME） and traditional radical resection in the treatment of stage Ⅲ colon cancer. Methods The clinical data of 113 patients with stage Ⅲ colon cancer treated in our hospital from June 2011 to June 2015 were analyzed retrospectively. According to the different surgical procedures, all the cases were divided into CME group （58 cases received complete mesocolic excision） and traditional group （55 cases received traditional radical resection）. Statistical analysis was performed by using SPSS17.0 software, intraoperative and postoperative measurement data were expressed as （ ±s） and were compared by student’s t test. Postoperative complication rate, recurrence rate and mortality rate within 2 years were compared by chi-square test. P less than 0.05 was considered as significant difference. Results The number of removed lymph nodes, intraoperative blood loss in CME group were significantly better than those in traditional group, the difference was statistically significant （P 〈0.05）; There was no significant difference in operation time, proximal margin length, distal margin length, first flatus time, first defecation time, ground activity time, postoperative fasting time, average hospitalization time, and postoperative complication rate between the two groups （ P〉0.05）. The recurrence rate within 2 years in CME group was significantly lower than that in traditional group （5.2% vs. 21.8%, χ^2=6.795, P =0.009）; The mortality rate within 2 years in CME group was significantly lower than that in traditional group （3.4% vs. 12.7%, χ^2=4.310, P =0.038）. Conclusion Complete mesocolic excision has better efficacy than traditional radical resection in treatment of stage Ⅲ colon cancer, with advantages of more extensive lymph node dissection, less intraoperative bleeding, and decreased recurrence rate.
作者
张满赐
赵敏
Zhang Manci;Zhao Min(Department of General Surgery,People＇s Liberation Army 11th Hospital,Yining Xinjiang 835000,China)
出处
《中华普外科手术学杂志（电子版）》
2018年第5期435-437,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
结肠肿瘤
结肠系膜
全结肠系膜切除术
剖腹术
治疗结果
Colonic Neoplasms
Mesocolon
Complete Mesocolic Excision
Laparotomy
Treatment Outcome
