肿瘤特异系膜切除术与全系膜切除术治疗中上段直肠癌的疗效分析

Curative effects comparison of tumor-sepecific mesorectal excision and total mesorectal excision in the treatment of upper middle section of rectal cancer

目的通过直肠癌肿瘤特异系膜切除术(TSME)与直肠癌全系膜切除术(TME)临床效果的比较,探讨TSME的应用价值。方法 DukesA、B、C期中低位直肠癌患者80例分为TSME组(42例)和TME组(38例),比较两组患者术后的复发率、存活率、吻合口瘘及直肠系膜内淋巴结清除情况,评价TSME的效果。结果 TSME组与TME组在手术后复发率、存活率、直肠系膜内淋巴结清除情况方面的比较,差异无统计学意义(P>0.05);TSME组吻合口瘘发生率明显低于TME组,差异具有统计学意义(P<0.05)。结论 TSME能够保证直肠癌手术根治性,与TME手术比较,TSME手术能够减少并发症,值得临床推广应用。

Objective To explore the application value of tumor-specific mesorectal excision （TSME） by comparing the clinical effects between TSME and total mesorectal excision （TME）. Methods A total of 80 patients with Dukes A, B and C upper middle section of rectal cancer were divided into TSME group （n=42） and TME group （n=38）. The recurrence rate, survival rate, anastomotic fistula and cleaning of lymphnode of mesentery were compared between the two groups, and effect of TSME was evaluated. Results There was no significant differences of recurrence rate, survival rate and cleaning of lymphnode of mesentery between the TSME group and the TME group （P〉0.05）. Incidence of anastomotic fistula of TSME group was significantly lower than that of the TME group, and the difference was statistically significant （P〈0.05）. Conclusion TSME can guarantee the radical excision of rectal cancer and reduce the incidence of complications, compared with TME, and it is worthy of clinical promotion.