【摘要】 目的评估全结肠系膜切除术(complete mesocolic excision,CME)在右半结肠癌根治术中实施的安全性和可行性。方法回顾性分析接受CME手术(35例)和传统手术(36例)患者的临床病理资料,评估两组患者的手术效果。结果两组患者性别、年龄、肿瘤部位分布无显著性差异,平均手术时间亦无明显差异。CME手术组术中平均出血量(138.3±82.5)ml,明显少于传统手术组的(181.9±53.7)ml(P<0.05)。CME手术对术后病理分期如T分期、N分期以及TNM分期无影响,CME手术组平均活检淋巴结数目为(17.7±5.8)枚,而传统手术组为(13.6±2.5)枚,CME手术可提高术后活检淋巴结的数目(P<0.05)。两组患者术后总体并发症、感染性并发症以及非感染性并发症发生率均无显著差异。结论 CME手术治疗右半结肠癌患者安全、可行、有效,可保证切除系膜的完整性和清扫更多的淋巴结,并不增加手术的风险。更多还原

【Abstract】 Objective To assess the feasibility and safety of complete mesocolic excision (CME) in elective radical resection for right hemi-colon cancer. Methods The clinical data of 35 cases undergoing radical right hemi-colon resection with CME and 36 patients with traditional procedures were retrospectively analyzed to explore the effect and surgical outcomes between the two groups. Results There were no significant differences in age , gender, and tumor location between the two groups. No difference was found in mean operation time between the two groups. The mean blood loss was (138.3 ±82.5)ml in the CME group,significantly less than (181.9 ±53.7)ml in the traditional surgery group (P<0.05). There were no significant differences in T , N, and TNM stages between the two groups. The mean number of lymph nodes harvested was (17.7±5.8) in the CME group, significantly higher than (13.6±2.5) in the traditional group (P<0.05). There were no differences in postoperative infectious and non-infectious complication rates between the two groups , and there were no severe complication such as ureteral injury both in the two groups. Conclusions The application of CME in radical resection for right hemi-colon cancer is feasible, safe and effective. CME can improve the surgical quality with the integrity of mesocolon, and have more harvested lymph nodes and satisfactory postoperative complication rate.更多还原