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右半结肠癌完全结肠系膜切除术清扫肠系膜根部淋巴结效果观察
余开平1, 朱玲华2
1.淳安县中医院外科;2.浙江大学医学院附属邵逸夫医院外科
摘要:
目的 探讨右半结肠癌行完全结肠系膜切除术(CME)清扫肠系膜根部淋巴结的临床疗效。方法 以2010年12月 至2012 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:  全结肠系膜切除  右半结肠癌  淋巴结清扫  短期预后
DOI:
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基金项目:
Clinical efficacy of CME in right-side colon cancer
YU Kaiping,ZHU Linghua
Chun'an Traditional Chinese Medical Hospital
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 Ⅲ patients in CME group had lower 2 year local recurrence rate and higher survival rate than control group [38.2% vs 64.8%, 88.2% vs68.5%, all P<0.05]. Conclusion CME is effective and safe for right-side colon cancer.
Key words:  Complete mesocolic excision (CME)  Right-sided colon cancer  Lymph node dissection  Short-term prognosis