右半结肠癌完全结肠系膜切除.PDFVIP

江医学2015 年第37 卷第12 期 右半结肠癌完全结肠系膜 除 术清扫肠系膜根部淋巴结效果 观察 余开平 朱玲华 【摘要 】 目的 探讨右半结肠癌行完全结肠系膜 除术（CME ）清扫肠系膜根部淋巴结的临床疗效。方法 以2010 年 12 月 至20 12 年 12 月行CME 的57 例右半结肠癌患者作为观察组，同期接受传统结肠癌根治术的99 例右半结肠癌患者作为对照组，对 两组患者的淋巴结清扫数量、平均出血量、手术时间、住院时间、术后排气、排便时间、手术并发症、2 年局部复发率及生存率等情况进 行比较，初步评价CME 清扫肠系膜根部淋巴结的临床效果。 结果 CME 组与对照组总淋巴结清扫数量分别为（22.6 ±2.8 ）、 （14.6 ±2.7 ）枚，CME 组淋巴结清扫数量明显多于对照组（P 0.05 ）；CME 组平均出血量为（167.4 ±20.8 ）ml ，对照组为（205.4 ± 19.3 ）ml ，CME 组出血量少于对照组（P 0.05 ）；两组的手术时间、住院时间、术后排气、排便时间比较差异均无统计学意义（均P ＞ 0.05 ）；CME 组手术并发症发生率与对照组比较差异无统计学意义（P ＞0.05 ）；Ⅲ期患者CME 组2 年局部复发率38.2％、生存率 88.2％，对照组分别为64.8％和68.5％，两组差异有统计学意义（均P 0.05 ）。结论 右半结肠癌患者采用CME 清扫肠系膜根部 淋巴结是安全和有效的。 【关键词】 全结肠系膜 除 右半结肠癌 淋巴结清扫 短期预后 Clinical efficacy of CME in right-side colon cancer , China 【Abstract 】 Objective To explore the clinical efficacy of complete mesocolic excision(CME) in right-side colon cancer patients. Methods Fifty seven cases with right-side colon cancer received CME from December 2010 to December 2012 were enrolled in the CME group, and 99 subjects received traditional operation served as the control group. Lymph node dissection, mean blood loss, operation time, length of stay , time of exhaust and defecation postoperation, postoperative complications, as well as 2 year local recurrence rate and survival rate were compared between two groups. Results Mean number of Lymph node dissection was higher in CME group than control group [22.6 ±2.8 vs 14.6 ±2.7, P 0.05]. Mean blood loss in CME group was less than control group [(167.4 ±20.8)ml vs (205.4 ±19.3)ml, P 0.05]. There were no significant difference of mean operative time, mean time of exhaust and defecation postoperation, and length of stay between two groups (all P ＞0.05). Stage Ⅲpatients in CME group had lower 2 year local recurrence rate and higher survival rate than control group [38.2% vs 64.8% , 88.2% vs 68.5%, all P 0.05]. Conclusion CME