完整结肠系膜切除术治疗结肠癌的短期疗效和安全性评价

Short-term efficacy and safety of complete mesocolic excision for treatment of colon cancer

目的探讨完整结肠系膜切除术(CME)治疗结肠癌的短期疗效及其安全性的相关影响因素。方法回顾性分析我科47例行传统根治手术(CME组)及38例行完整结肠系膜切除术(传统组)治疗结肠癌的患者临床资料,比较2组患者相关影响因素及短期疗效。结果 CME组与传统手术组平均清扫淋巴结分别为(21.6±7.5)枚、(13.9±7.1)枚,且在各期手术淋巴结清扫数目显著多于传统手术组,存活率、复发率上分别为100%和80.9%,10.5%和46.8%,术后排气、排便及住院时间无显著差异,CME组的并发症率也低于传统手术组。结论完整结肠系膜切除术增加了周围淋巴结的清扫,是提高结肠癌患者术后存活率,降低复发率的有效措施,能提高手术质量,疗效确实、可靠。

Objective To investigate the short-term efficacy and safety-related factors of the complete mesocolic excision and traditional operation for treating colon cancer. Methods The data of 38 patients with colon cancer who received complete mesocolic excision and 47 ca- ses who treated by traditional operation were analyzed retrospectively, and the short-term efficacy and relative factors were compared. Results The average cleaned lymph nodes of CME group and traditional group were respectively （21.6 -7.5 ） and （13.9 ＋ 7.1 ）, and the number of cleaned lymph nodes at every stage of surgery in CME group was significantly more than that in traditional group. The survival rates and the recurrence rates of two groups were respectively 100% vs. 80.9% , 10.5% vs. 46.8%. There was no significant difference in the postopera- tive exhaust, defecation and hospitalization time. But the rate of complications in CME group was lower than that in traditional group. Conclu- sion For patients with colon cancer,the complete mesocolic excision can clean the surrounding lymph nodes,improve the survival rate, re- duce the relapse rate, which enhances the quality of operation, improves surgical safety, with reliable efficacy, and worthy of further research and extension in clinic.