完整结肠系膜切除联合中央血管结扎技术在右侧结肠癌术中应用探讨

Discussion on application of complete mesocolic excision united central vascular ligation in right radical colonectomy

目的探讨完整结肠系膜切除(complete mesocolic excision,CME)联合中央血管结扎(central vascular ligation,CVL)技术在右侧结肠癌手术治疗中的应用效果。方法回顾分析32例右侧结肠癌CME联合CVL技术的临床资料,并与常规手术组比较。结果两组均无切口感染及吻合口瘘并发症,对照组有1例患者出现粘连性肠梗阻;CME组32例结肠系膜均完整,无破损,对照组30例中有18例结肠系膜破损,两组比较差异有统计学意义(χ2=13.408;P<0.001);CME联合CVL组淋巴结清扫平均数(14.2±2.6)枚,对照组为(8.3±1.9)枚,两组比较差异有统计学意义(t=36.54;P<0.001),其中CME联合CVL组淋巴结阳性率为42.3%,对照组为37.8%,两组比较差异无统计学意义(P>0.05)。结论 CME能保证结肠系膜的完整切除、同时能收获更多的淋巴结,有利于结肠癌的根治性完整切除。

Objective To investigate the effect of complete mesocolic excision（CME） united central vascular ligation（CVL） in right hemicolectomy for colonic cancer. Methods Retrospective analysis the clinical data of 32 patients with right hemicolectomy for colonic carcinoma undergoing CME combined with CVL,and compared with control group of 30 patients with underwent tradi-tional radical resection. Results The two groups had no incision infection and anastomotic leakage. 1 patient had intestinal ob-struction of adhesion in control group,32 cases of mesocolon were complete resected in CME combined with CVL group,18 cases of mesocolon were not complete resected in the control group,the difference has statistical significant （χ2=13.408,P〈0.001）;The average number of lymph nodes harvested for CME combined with CVL group was 14.2±2.6,and the control group was 8.3±1.9, the difference has statistical significance too （t=36.54,P〈0.001）. Lymph node positive rate in CME combined with CVL group was 42.3%,while the control group was 37.8%, but there was no statistical significance（P〉0.05）. Conclusion CME technique for colon cancer can achieveen bloc resection of mesocolon,and have optimal lymph nodes harvest,which is conducive to complete resection of colon cancer.