完整结肠系膜切除在结肠癌手术治疗中的临床应用

Complete mesocolic excision in the surgical treatment of colon cancer

目的探讨完整结肠系膜切除在结肠癌手术治疗中的临床疗效。方法选取2012年1月至2012年12月收治的30例结肠癌患者且经完整结肠细膜切除的患者的临床资料进行回顾性分析,并与2011年1月至2011年12月收治的30例结肠癌患者行结肠癌根治手术的患者进行对比分析,观察患者临床各个指标的变化、短期疗效、安全性及远期生存率的比较和分析,对比两种方法的效果。结果完整结肠系膜切除术效果显著,术后出血量较结肠根治手术少,且淋巴结清除数量多(P<0.05);术后感染1例,吻合口瘘1例,复发1例,并发症和复发发生率分别为6.67%和3.33%,而结肠癌根治术术后感染3例,吻合口瘘2例,复发4例,并发症和复发发生率分别为16.67%和13.33%,两组相比差异均有统计学意义(P<0.05);随访1年和3年后,完整结肠系膜切除术患者生存率分别为93.33%(28/30)和76.67%(23/30),而结肠癌根治术患者分别为76.67%(23/30)和53.33%(16/30),两组相比差异具有统计学意义(P<0.05)。结论结肠癌患者采用完整结肠系膜切除的手术方法可最大化地切除病灶,清扫淋巴结,在提高患者短期存活率、降低术后并发症发生率和复发率上显著优于结肠根治术,可推广应用。

Objective To analyze the effect of complete mesoeolic excision in the surgical treatment of colon cancer. Methods 30 patients with colon cancer from January 2012 to December 2012 in our hospital were studied. 30 patients with colon cancer from January 2011 to December 2011 were selected as the control. Changes were observed in patients including various clinical indicators of short - term efficacy, safety and long - term survival. These indexes were compared and analyzed. Results Complete mesoeolic excision can achieve significant results, less postoperative bleeding compared with less radical surgery of the colon. The number of removing lymph nodes is more （ P 〈 0.05 ）, postoperative infection in one case, anastomotic fistula in one case, one case of recurrence. The complication, and recurrence rate was 6.67% and 3.33% respectively, while in the colon cancer radical surgery, postoperative infection were found in three cases, anastomotic leakage in 2 cases, 4 cases of recurrence. The complication, and recurrence rates of the colon cancer radical surgery were 16.67% and 13.33% , respectively. Compared the two groups, differences were statistically significant （ P 〈 0.05 ）. After followed up for 1 year and 3 years, the rate in complete resection mesoeo- Ion group was 93.33% （28/30） and 76.67% （23/30）, respectively, while the rates were 76.67% （23/30） and 53.33% （ 16/30）, in colon cancer surgery patients. The difference was statistically significant （ P 〈 0.05）. Conclusion Colon cancer patients with complete surgical exci- sion of the pieces mesocolon maximize removal of lesions, lymph nodes, in the short term to improve patient survival and reduce the incidence of postoperative complications. The relapse rate of this method was significantly better than colon resection. This method can be widely applied.