【作者】 田颖； 叶颖江； 韩亚妹； 高志冬； 王铁； 郭鹏； 杨晓东； 姜可伟； 尹慕军； 王杉；

【Author】 WANG Tie~1 YE Ying-jiang~(2*)HAN Ya-meil GAO Zhi-dong~2 GUO Peng~2 YANG Xiao-dong~2 JIANG Ke-wei~2 YIN Mu-jun~2 WANG Shan~2 1 Department of Surgery,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province,Cangzhou Hebei 061000 2Department of Gastrointestinal Surgery,Peking university People’ s Hospital,Beijing 100044, China

【机构】 北京市肛肠医院肛肠外科； 北京大学人民医院胃肠外科；

【摘要】 目的论证完整结肠系膜切除术(complete mesocolic excision CME)的短期疗效。方法分析2011年1月至2 01 1年1 0月北京大学人民医院胃肠外科接受根治术的6 2例Ⅰ一Ⅲ期结肠癌患者的临床资料,其中完整结肠系膜切除术31例,传统结肠癌根治术3 1例。结果两组患者在年龄、性别、肿瘤部位、肿瘤分期、分化程度等方面无明显差异。CME和传统结肠癌根治术患者清扫淋巴结总数分别为2 2.45±1.786枚和17.58±1.288枚(P<0.05),淋巴结阳性转移率分别1 1.35%和1 2.43%(P>0.05),9.68%(3/31)的CME患者高位血管根部淋巴结阳性;术中出血量分别为1 23.5±17.59ml和1 43.5±15.34m1(P>0.05);手术后3天内腹腔引流量分别为295.8±49.90ml和1 22.0±20.27ml(P<0.05);住院期间发生肠梗阻的病例分别为4例和5例,淋巴瘘分别为2例和0例,切口裂开各1例,均无统计学意义;术后住院日分别为1 2.35±1.1 76天和1 5.1 3±1.298天(P>0.05);住院费用分别为53397±3294元和5 1 0 65±248 1元,(P>0.05)。结论完整结肠系膜切除术(CME)较传统结肠癌根治术清扫淋巴结效果更多还原

【Abstract】 Objective To demonstrate the short-term effect of complete mesocolic excision(CME). Methods To analyze clinical data of 62 cases of colon cancer(Ⅰ—Ⅲphase)with radical resection including CME surgery group of 31 cases and traditional surgery group of 31 cases from January,2011 to October,2011 at Peking University people’s Hospital.Result There were no obvious differences in the age,sex,tumor site,and tumor staging and differentiation degree.The number of the eliminating of lymph nodes of CME and traditional colon cancer resection were respectively 22.45±1.786 and 17. 58±1.288(P<0.05),positive metastases rate was 11.35%and 12.43%,and the rate of positive lymph nodes in mesentery root was 9.68%,(3/31)in CME surgery group.Operative bleeding loss were 123. 5±17.59ml and 143.5±15.34ml(P>0.05).Within 3 days after the operation abdominal drainage volume were 295.8±49.90ml and 122.0±20.27ml(P<0.05).Intestinal obstruction occurred during hospitalization were 4 cases and 5 cases,lymph fistula were 2 cases and 0 case,wound dehiscence was 1 case and 1 case,there was no statistically significant.Postoperative hospitalization were 12.35±1. 176 days and 15.13±1.298 days(P>0.05),hospitalization costs were RMB 53397±3294 and RMB 51065±2481(P>0.05). Conclusion CME compared with traditional radical surgery for colon cancer sweeps lymph nodes more thoroughly,effectively reduces the risk of the omission of positive lymph nodes,does not increase the incidence of intraoperative and postoperative complications.更多还原