结肠系膜完整切除在结肠癌手术中的应用

Application of complete excision of mesocolon in the operation of colon carcinoma

目的：观察结肠系膜完整切除在结肠癌手术中的应用效果。方法选取本院2013年1月~2014年3月收治的70例结肠癌患者为临床研究对象，将所有患者随机分为实验组和对照组。实验组采用结肠系膜完整切除术（CME），对照组患者则采用传统结肠癌根治术进行治疗。记录两组患者的淋巴结清扫数量、3 d引流量、引流管放置时间、排气时间、进食时间和住院时间，同时记录两组患者的并发症发生情况。结果实验组患者的淋巴结清扫数量显著多于对照组；实验组术后3 d引流量多于对照组，住院时间短于对照组，差异有统计学意义（P〈0.05），但两组患者的引流管放置时间、排气时间、进食时间差异无统计学意义（P〉0.05）。实验组患者的并发症发生率为5.7%（2/35），对照组为14.3%（5/35），实验组的并发症发生率低于对照组，差异有统计学意义（P〈0.05）。结论结肠癌系膜完整切除术比传统的结肠癌根治术的效果更好，能清扫更多淋巴结，同时能有效降低术后各种不良反应的发生率，值得在临床推广应用。

Objective To observe the application effect of complete excision of mesocolon in the operation of colon carcinoma. Methods 70 patients with colon carcinoma admitted into our hospital from January 2013 to March 2014 were selected as clinical research objects and randomly divided into experimental group and control group.In the exper-imental group,complete mesocolic excision （CME） was applied,while in the control group,traditional radical operation for carcinoma of colon was adopted.Amount of lymph node dissection,volume of drainage 3 days after surgery,placement time of drainage tube,time of exhaust,time to take food,and hospital stay as well as occurrence of complications were recorded in both groups. Results The amount of lymph node dissection in the experimental group was more than that in the control group.In the experimental group,the 3-day volume of drainage after surgery was more than that in the con-trol group,and hospital stay was shorter in comparison with that in the control group,which displayed statistical differ-ences （P〈0.05）.There was no significant difference in placement time of drainage tube,time of exhaust,or time to take food （P〉0.05）.The incidence of complications in the experimental group was 5.7% （2/35）,while in the control group,the incidence was 14.3% （5/35）.After comparison,the incidence of complications in the experimental group was lower than that in the control group with a statistical difference （P〈0.05）. Conclusion Compared with the traditional radical opera-tion for carcinoma of colon,CME can obtain a better effect by cleaning more lymph nodes and effectively reducing the incidence of postoperative complications,which is worthy of expansion and application in clinic in future.