摘要
目的探究完整结肠系膜切除术(complete mesocolic excision,CME)用于老年结肠癌的手术治疗效果。方法选取2017年9月—2022年9月湖北省潜江市中心医院收治的120例老年结肠癌患者为研究对象,根据接受的不同手术方式分为两组,对照组(n=58)行常规腹腔镜结肠癌根治术,观察组(n=62)行腹腔镜CME。比较两组手术指标(手术切口长度、术中出血量、手术时间、术后排气时间、术后下床时间及术后住院时间)、淋巴结(右半结肠淋巴结、左半结肠淋巴结、阳性转移淋巴结)清除数目、应激反应、并发症发生率及术后6个月与术后12个月总复发率。结果比较两组手术时间、术中出血量、手术切口长度、术后排气时间、术后下床时间、术后住院时间,差异无统计学意义(P均>0.05)。观察组右半结肠淋巴结、左半结肠淋巴结、阳性转移淋巴结的清除数目均多于对照组,差异有统计学意义(P均<0.05)。术后2 h两组的肾上腺素、皮质醇及促肾上腺皮质激素均高于术前,差异有统计学意义(P均<0.05);但两组间应激反应(肾上腺素、皮质醇及促肾上腺皮质激素)指标比较,差异无统计学意义(P均>0.05)。观察组并发症发生率低于对照组,差异无统计学意义(P>0.05)。观察组术后6个月和12个月的总复发率为3.23%(2/62),低于对照组的15.52%(9/58),差异有统计学意义(χ^(2)=5.437,P<0.05)。结论与常规腹腔镜结肠癌根治术比较,腹腔镜CME能提高淋巴结清扫数量,降低肿瘤复发风险,不影响手术进程与术后恢复,且不会加大患者机体应激反应。
Objective To explore the effect of complete mesocolic excision(CME)on the surgical treatment of colon cancer in the elderly.Methods A total of 120 elderly patients with colon cancer admitted to Hubei Qianjiang Central Hospital from September 2017 to September 2022 were selected as the research objects.Ac⁃cording to the different surgical methods,they were divided into two groups.The control group(n=58)underwent conventional laparoscopic radical resection of colon cancer,and the observation group(n=62)underwent laparo⁃scopic CME.The surgical indexes(incision length,intraoperative blood loss,operation time,postoperative ex⁃haust time,postoperative ambulation time and postoperative hospital stay),number of lymph nodes(right colon lymph nodes,left colon lymph nodes,positive metastatic lymph nodes),stress response,complications and total recurrence rate at 6 months and 12 months after operation were compared between the two groups.Results There were no significant differences in operation time,intraoperative blood loss,incision length,postoperative exhaust time,postoperative ambulation time and postoperative hospital stay between the two groups(all P>0.05).The number of right colon lymph nodes,left colon lymph nodes and positive metastatic lymph nodes in the observation group were more than those in the control group,and the differences were statistically significant(all P<0.05).The levels of epinephrine,cortisol and adrenocorticotropic hormone in the two groups at 2 h after operation were higher than those before operation,and the differences were statistically significant(all P<0.05).But there were no significant difference stress response indexes(adrenaline,cortisol and adrenocorticotropic hormone)between the two groups(all P>0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was not statistically significant(P>0.05).The total recur⁃rence rate of the obsercation group at 6 months and 12 months after operation was 3.23%(2/62),which was lo
作者
程军
CHENG Jun(Hubei Qianjiang Central Hospital,Qianjiang 433199,Hubei,China)
出处
《世界复合医学（中英文）》
2024年第8期119-123,共5页
World Journal of Complex Medicine
关键词
完整结肠系膜切除术
腹腔镜结肠癌根治术
结肠癌
应激反应
Complete mesocolic excision
Laparoscopic radical resection of colon cancer
Colon cancer
Stress response
