结肠癌根治术不同网膜切除方式对预后的影响

Effect of different omentum excision on prognosis of patients after radical resection for colonic carcinoma;a randomized study

目的探讨结肠癌根治术大网膜清扫方式对术后生存及肿瘤复发影响。方法从2004年1月至2006年1月期间,实施左或右半结肠癌根治术的病人123例,术前随机分人半网膜切除组(A组62例)和全网膜切除组(B组61例)。统计学比较三年生存率和总复发率。结果 116例完成三年随访。A、B组三年生存率和总肿瘤复发率分别为74%,72%和32%,31%,其差异无统计学意义(P>0.05)。而A、B组手术时间、脾包膜撕裂例数及住院费用分别为117.87 vs.147.29分钟;0 vs.3例;7810 vs.8754元,其差异有统计学意义(P<0.05)。结论全网膜切除术未延长结肠癌患者三年生存率和复发率,增加了住院费用及脾包膜撕裂副损伤危险。

Objective To study the effect of different omentum excision on prognosis of patients after radical resection for colonic carcinoma.Methods One hundred and twenty three patients suitable for radical resection of right or left colonic carcinoma from Jan 2004 to Jan 2006 were enrolled.The patients were randomly divided into to two groups and received half greater omentum excision(Group A,n=62) or total greater omentum excision(Group B,n=61).The 3-year-survival rate and total recurrence rate were compared between the two groups.Results One hundred and sixteen patients completed follow-up for 3 years.The 3-year-survival rates of group A and B were 74% and 72%,and the total recurrence rates were 32%and 31%respectively.There was no significant differences between the two groups(P>0.05).The average operating time,hospitalization cost of group A and B were 117 and 147 minutes,7810 and 8754 yuan respectively.Splenic peplos laceration happened in no patients in group A and 3 patients in group B.There were significant differences between the two groups(P<0.05).Conclusions Total greater omentum excision has no benefit for colonic carcinoma recurrence and 3-year survival rate.It may increase operating time, hospitalization cost,and the risk of splenic peplos laceration.