左手控制技术在右半结肠癌完整结肠系膜切除中的应用

Left hand control technology in complete mesocolic excision in patients with right colon cancer

目的探讨左手控制技术在右半结肠癌全结肠系膜切除(CME)中的应用。方法选择右半结肠癌患者共70例,分为研究组和对照组各35例,其中研究组采用右半结肠癌完整肠系膜切除,术中采用左手控制技术,对照组采用传统手术方法,比较两组的手术效果和预后。结果两组在手术时间、术中出血量、术后排气排便时间、术后并发症、住院时间无显著差异(P>0.05),但是研究组淋巴结清扫数均值显著高于对照组(P<0.05)。研究组随访中发现复发3例(8.82%),死亡1例(2.94%)。对照组发现复发9例(27.3%),死亡6例(18.18%),研究组复发率和死亡率显著低于对照组(P<0.05)。结论采用左手控制技术在右半结肠癌完整结肠系膜切除术中较传统术式能明显提高右半结肠癌患者的生存率。

Objective To investigate the left hand control technology in complete mesocolic excision（ CME）in patients with right colon cancer. Methods Seventy patients with right colon cancer were divided into study group and control group（35 cases each）,in which,the full right colon mesentery resection and left hand control technology was used in the study group,and conventional surgical methods in the control group. Surgical results and prognosis were compared. Results Operative time,blood loss,postoperative exhaust defecation time,postoperative＆amp;nbsp;complications,length of hospital stay had no significant difference between two groups,but there was significant difference between the two groups in the number of lymph node dissection. In study group,the mean number of lymph node dissection was significantly higher than the control. Fol-low-up in study group found that 3 cases had recurrence（8. 82%）and 1 patient died（2. 94%）,but in control group,we found 9 cases of re-currence（27. 3%）and 6 cases（18. 18%）died. Recurrence and mortality in study group was significantly lower than the control group. Conclu-sion The left hand control technique in CME can significantly improve overall survival rate in patients with right colon cancer compared with con-ventional surgical procedures.