进展期右半结肠癌D_3术式与D_2术式的比较

Comparation of D_3 with D_2 lymphadenectomy for advanced right colon cancer

目的 探讨应用D3 廓清术治疗进展期右半结肠癌 (ARCC)的安全性、合理性和可行性。方法 97例ARCC患者随机分组为D2 廓清术组 (5 5例 )和D3 廓清术组 (4 2例 ) ,比较两组的相关临床资料。结果 D3 廓清术较D2 廓清术的手术创伤程度增加 ,但并发症未有明显增多 ,且治愈性根治或非治愈性根治切除比例有明显提高 ,术后 3,5年生存率亦有明显提高 (88 1%和 73 8%∶72 8%和 5 2 7% ) (P <0 0 5 )。结论 对于ARCC ,D3 术式较D2术式能明显提高患者的 5年生存率。D3 廓清术是安全、合理和可行的 ,应予开展 。

Objective To study the safety, reasonableness and feasibility of D 3 lymphadenectomy(LC) for advanced right colon cancer(ARCC). Methods 97 cases of ARCC were divided randomly into two groups: D 2.LC group (55cases) and D 3 LC group (42cases). The climical data between D 3 LC and D 2LC were compared. Results Comparing to D 2 LC,D 3 had higher operative invasive degree, but the incidence of postoperative complications did not increase, the ratio of the curable resection and the three-year and five-year survival rate after operation were significantly higher (88.1% and 73.8% vs 72.8% and 52.7%) (all P <0.05). Conclusions Extensive right colon cancer radical resection (D 3) has signeficantly higher five-year survival rate than that of traditional right colon cancer radical resection (D 2). D 3 lymphadenectomy for ARCC is safe, reasonable and feasible, and should be introduced.