【摘要】 目的探讨右半结肠癌根治术中全结肠系膜切除(CME)的内侧界限选择。方法将96例右半结肠癌患者随机分为对照组和研究组,每组48例。对照组以肠系膜上静脉(SMV)左侧为CME内侧界限,研究组以肠系膜上动脉(SMA)左侧为CME内侧界限。比较2组临床疗效及并发症发生率。结果研究组手术时间、肠道排气时间、引流时间及术后住院时间均长于对照组,差异有统计学意义(P <0.05)。研究组淋巴结清扫数量多于对照组,差异有统计学意义(P <0.05)。研究组术后肠梗阻、乳糜漏及总并发症发生率高于对照组,差异有统计学意义(P <0.05)。结论除非术前或术中评估发现SMA表面或周边存在可疑淋巴结,一般仍以SMV左侧为清扫界限。更多还原

【Abstract】 Objective To explore the selection of medial boundary for complete mesocolic excision(CME) in radical operation for right colon cancer. Methods Ninety-six patients with right colon cancer were randomly divided into control group and study group,with 48 cases in each group. The left superior mesenteric vein(SMV) was selected as the medial boundary of CME in the control group,and the left superior mesenteric artery(SMA) was selected as the medial boundary of CME in the study group. The clinical efficacy and the incidence of complications were compared in the two groups. Results The operative time,intestinal exhaust time,drainage time and postoperative hospitalization time in the study group were significantly longer than those in the control group(P <0. 05). The number of lymph node removed in the study group was significantly more than that in the control group(P < 0. 05). The incidence rates of intestinal obstruction,chylous leakage and total complications in the study group were significantly higher than those in the control group(P < 0. 05).Conclusion The left side of SMV is usually used as boundary for lymph node dissection unless suspicious lymph nodes on or near SMA are found in the preoperative or intraoperative evaluation.更多还原