摘要
目的探讨对比以肠系膜上动脉(SMA)为导向和肠系膜上静脉(SMV)为导向的腹腔镜下右半结肠癌根治术的临床疗效与短期预后对比。方法选取2020年1月至2022年10月收治的80例cT2-4和(或)N0-2M0的右半结肠癌患者作为研究对象,将其随机分为观察组和对照组,各40例。观察组采用以SMA为导向的腹腔镜下右半结肠癌根治术治疗,对照组采用以SMV为导向的腹腔镜下右半结肠癌根治术治疗,对比两组疗效及预后。结果两组发病的一般情况、手术时间、留置胃管时间、恢复排气时间、术后禁食时间、术后放置引流时间、术后营养指标、并发症总发生率及术后住院时间等差异无统计学意义(P>0.05);观察组清扫到的淋巴结明显多于对照组,差异有统计学意义(P<0.05),其中观察组送检SMA前方及左侧淋巴结(No.D3),检出淋巴结数量249枚,确诊D3转移的患者7例(17.5%),阳性淋巴结13枚(5.2%)。结论以SMA为导向的腹腔镜下右半结肠癌根治术在未增加并发症发生率且安全性高的同时,更彻底地清扫淋巴结,减少肿瘤复发,有望显著改善患者预后。
Objective To compare the clinical efficacy and short⁃term prognosis of laparoscopic radical resection of right colon cancer guided by superior mesenteric artery and superior mesenteric vein.Methods 80 patients with right colon cancer of cT2⁃4 and/or N0⁃2M0 admitted from January 2020 to October 2022 were selected as the research objects,and they were randomly divided into observation group and control group,with 40 patients in each group.The observation group was treated with SMA⁃oriented laparoscopic radical resection of right colon cancer,while the control group was treated with SMV⁃oriented laparoscopic radical resection of right colon cancer.The curative effect and prognosis of the two groups were compared.Results There was no significant difference between the two groups in general condition,operation time,gastric tube placement time,recovery time of farting,postoperative fasting time,postoperative drainage time,postoperative nutritional index,total incidence of complications and postoperative hospitalization time(P>0.05).The lymph nodes in the observation group were significantly more than those in the control group,and the difference was statistically significant(P<0.05).In the observation group,the lymph nodes in the anterior and left side of superior mesenteric artery were examined(No.D3),and 273 lymph nodes were detected,and Seven patients(17.5%)were diagnosed with D3 metastasis,and 13 lymph nodes were positive(5.2%).Conclusion Laparoscopic radical resection of right colon cancer guided by superior mesenteric artery,without increasing the incidence of complications and high safety,can more thoroughly clean lymph nodes and reduce tumor recurrence,which is expected to significantly improve the prognosis of patients.
作者
张冉昊
乔文娟
师梦伟
穆冬冬
郑连生
ZHANG Ranhao;QIAO Wenjuan;SHI Mengwei;MU Dongdong;ZHENG Liansheng(Graduate School of Baotou Medical College,Baotou 014040,China;Digestion Minimally Invasive Center,the Second Affiliated Hospital of Baotou Medical College,Baotou 014030,China)
出处
《实用医学杂志》
CAS
北大核心
2024年第2期225-230,共6页
The Journal of Practical Medicine
基金
内蒙古自治区卫生健康科技计划项目(编号:202201442)
包头市卫生健康科技计划项目(编号:wsjkkj020)。
关键词
右半结肠癌
肠系膜上动脉
肠系膜上静脉
淋巴结
right colon cancer
superior mesenteric artery
superior mesenteric vein
lymph nodes
