完整结肠系膜切除术与传统结肠癌根治术治疗右半结肠癌的对比

Complete Mesocolic Excision Versus Traditional Radical Resection in the Right Colon Cancer

目的：比较完整结肠系膜切除术（ CME ）与传统结肠癌根治术治疗右半结肠癌的短期疗效和安全性。方法回顾性分析2012年1月～2012年9月笔者所在科室19例接受传统结肠癌根治术治疗（对照组）的右半结肠癌患者与2012年10月～2013年9月23例接受CME手术治疗（ CME组）的临床资料，比较两组患者的短期治疗效果和安全性。结果 CME组淋巴结清扫数量（29．48±2．284）明显多于对照组（17．00±1．065），P＜0．01；ⅢB、ⅢC患者阴性淋巴结数量CME组（20．00±2．872）明显多于对照组（10．14±1．625），P＝0．013。手术时间、术后并发症、术后排气排便时间，P＞0．05，CME组与传统手术组差异无统计学意义。结论 CME手术可以整块、彻底地切除癌灶和系膜组织，从而达到淋巴结清扫的最大化。尽管CME手术切除范围大，但不会增加手术风险及术后并发症发生率，术后短期疗效良好。

Objective To compare the short-term efficacy and safety between complete mesocolic excision （ CME） and traditional radical operation in the treatment of the right colon cancer .Methods To Retrospectively analyze of the clinical data about 19 patients under-going surgery for the treatment of traditional colon cancer （ control group ） of the right colon cancer patients from January 2012 to September 2012 and 23 cases underwent CME operation treatment （group CME） from October 2012 to September 2013 that the writer＆#39;s department did, and then to compare the short-term efficacy and safety.Results The amount of lymph node dissection in group CME （29.48 ±2.284） was higher than that of control group（17.00 ±1.065）（P〈0.01）,and the number of CME group（20.00 ±2.872） was higher than the control group（10.14 ±1.625） of patients with negative lymph node of ⅢB,ⅢC（P=0.013）.There were no significant difference between CME group and the traditional operation group in operation time ,postoperative exhaust defecation time and postoperative complications （P〉0.05）. Conclusion The CME operation can cut off the whole ,complete resection of tumor and mesenteric tissue ,so as to achieve the maximization of lymph node dissection .Although the CME operation range ,but do not increase the risk of operation and postoperative complication rate ,and postoperative short-term efficacy is good .