摘要
目的:探讨腹腔镜右半结肠癌D3根治术+幽门下和胃网膜弓淋巴结(IGLN)清扫术治疗局部进展期结肠肝曲癌的临床疗效。方法:回顾性分析2018年5月至2023年10月60例局部进展期结肠肝曲癌患者资料。根据淋巴结清扫范围不同分为观察组和对照组,每组患者各30例。对照组行腹腔镜右半结肠癌D3根治术,观察组行右半结肠癌D3根治结合IGLN清扫术。采用统计学软件SPSS 22.0分析数据。围手术期指标等计量资料用(x±s)表示,行独立样本t检验;并发症等计数资料用[例(%)]表示,采用χ^(2)检验或Fisher精确概率法;应用Kaplan-Meier法分析预后生存情况。P<0.05表示差异有统计学意义。结果:两组患者手术时间、术中出血量、淋巴结清扫数目、首次排气时间及住院时间差异均无统计学意义(P>0.05);共获取IGLN淋巴结480个,其中IGLN阳性率为15.4%。观察组患者总并发症虽多于对照组,但差异无统计学意义(P>0.05),均采取保守治疗后痊愈。Kaplan-Meier生存分析显示,观察组患者5年累积总生存率与累积无病生存率(76.7%、66.7%)明显高于对照组患者(53.3%、46.7%),差异有统计学意义(P<0.05)。结论:术中应用右半结肠癌D3根治术联合IGLN清扫术治疗局部进展期结肠肝曲癌可提高患者预后生存且安全可行,具有临床推广前景及价值。
Objective:To investigate the clinical effect of laparoscopic D3 radical resection of right hemicolonic carcinoma plus subpyloric and gastroepiploic lymph node(IGLN)dissection in the treatment of locally advanced hepatocolon carcinoma.Methods:The data of 60 patients with locally advanced hepatocellular carcinoma from May 2018 to October 2023 were retrospectively analyzed.The patients were divided into observation group and control group according to the different scope of lymph node dissection,30 patients in each group.The control group underwent laparoscopic D3 radical resection of right hemicoloma carcinoma,and the observation group underwent D3 radical resection of right hemicoloma carcinoma combined with IGLN dissection.Statistical software SPSS 22.0 was used to analyze the data.Perioperative indicators and other measurement data were expressed with(x±s),and independent sample t test was performed.Complications and other statistical data were represented by[cases(%)]usingχ^(2) test or Fisher exact probability method.Kaplan-Meier method was used to analyze the prognosis and survival.P<0.05 indicated that the difference was statistically significant.Results:There were no significant differences in operation time,intraoperative blood loss,number of lymph dissection,first exhaust time and hospital stay between the two groups(P>0.05).A total of 480 IGLN lymph nodes were obtained,of which the positive rate of IGLN was 15.4%.The total complications in the observation group were higher than those in the control group,but the difference was not statistically significant(P>0.05),and all patients were cured after conservative treatment.Kaplan-Meier survival analysis showed that 5-year cumulative overall survival and disease-free survival(76.7%and 66.7%)in the observation group were significantly higher than those in the control group(53.3%and 46.7%),and the difference was statistically significant(P<0.05).Conclusion:Intraoperative application of D3 radical resection of right half colon cancer combined with IGLN dissect
作者
崔宏帅
冯丽明
东维玲
韩博
Cui Hongshuai;Feng Liming;Dong Weiling;Han Bo(Department of Gastroenterology,Qingdao Central Hospital of Rehabilitation University(Qingdao Central Hospital),Qingdao Shandong Province 266000,China)
出处
《中华普外科手术学杂志（电子版）》
2024年第5期566-569,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
结肠肿瘤
腹腔镜
幽门下和胃网膜弓淋巴结
生存曲线
Colonic Neoplasms
Laparoscopes
Infrapyloric and Gastroepiploic Lymph Node
Lymph Node Excision
Survival Curve
