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全结肠系膜切除术在结肠癌根治术中的应用

Application of complete mesocolic excision in radical operation for colon cancer

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【作者】 孙建华吴泉峰张碧涛黄国全陈立波

【Author】 SUN Jian-hua;WU Quan-feng;ZHANG Bi-tao;Department of Gastrointestinal Surgery,the Central Hospital of Enshi Autonomous Prefecture;

【机构】 湖北省恩施州中心医院胃肠外科华中科技大学同济医学院附属协和医院普外科

【摘要】 目的 探讨全结肠系膜切除术(CME)在结肠癌根治术中的应用价值。方法 回顾性分析44例接受CME手术治疗及40例传统结肠癌根治术的结肠癌患者的临床资料,比较两组患者的近期疗效及安全性。结果 CME组和非CME组患者淋巴结清扫数量分别为(23.2±2.3)枚和(16.5±1.8)枚,差异有统计学意义(P<0.05);两组间Ⅰ期和Ⅱ期病例淋巴结清扫数量差异无统计学意义(P>0.05),Ⅲ期病例两组淋巴结清扫数量差异有统计学意义(P<0.05)。CME组和非CME组中位手术时间分别为195 min和145 min,差异有统计学意义(P<0.05)。两组患者术中出血量、术后恢复时间及术后并发症发生率比较,差异均无统计学意义(P>0.05)。结论 CME手术可以达到结肠癌的根治性完整切除,从而达到淋巴结清扫的最大化。术后近期疗效满意,其远期疗效尚待进一步观察。

【Abstract】 Objective To explore the application values of complete mesocolic excision(CME)in radical operation for colon cancer.Methods The clinical data of 44 cases of CME and 40 cases of traditional radical resection for colon cancer were analyzed retrospectively.Short-term efficacy and safety were compared between the two groups.Results The difference of removed lymph node number between the CME group(23.2±2.3)and control group(16.5±1.8)was significant(P<0.05).There were no significant differences in removed lymph node number between the stage Ⅰ and stage Ⅱ colon cancer patients(P>0.05).However,for the stage Ⅲ patients,difference in removed lymph node number between the CME group(25.8±3.6)and control group(17.6±2.1)was significant(P<0.05).The median operation times for the CME group and control group were 195 min and 145 min respectively(P<0.05).There were no significant differences between two groups in intraoperative blood loss,recovery time and postoperative complications(P>0.05).Conclusion The radical resection for colon cancer could be completed by complete mesocolic excision and achieve optimal lymph node harvest.The short-term efficacy is satisfactory,but the long-term efficacy needs further investigation.

  • 【文献出处】 临床外科杂志 ,Journal of Clinical Surgery , 编辑部邮箱 ,2014年08期
  • 【分类号】R735.35
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