顺行与逆行性淋巴结清扫切除术在右半结肠癌患者的疗效比较

The excision of right hemicolonic cancer with anterograde or retrograde clearance to lymph nodes

目的:比较右半结肠癌患者顺行性淋巴结清扫术与逆行性淋巴结清扫切除术的疗效。方法:将实施根治性切除(D3)的86例右半结肠癌患者分为A、B两组,其中A组43例行顺行性淋巴结清扫切除,B组43例行逆行性淋巴结清扫切除。比较两组患者术中情况以及预后。结果:两组患者平均手术时间、平均出血量和淋巴结清扫数等差别无统计学意义。术后肝转移顺行组6例(14.0%),逆行组14例(32.6%),5年生存率分别为72.1%和46.5%,差异均有统计学意义(P<0.05)。结论:右半结肠癌顺行性淋巴结清扫切除术是一种比较安全的手术方式,可减少肝转移的发生,提高患者生存质量。

Objective：To compare the excision effect of right hemicolonic cancer with antegrade or retrograde clearance to lymph nodes.Methods：86patients with right hemicolonic cancer（D3）undergoing redical resection were divided into A and B group.Group A,including 43 patients,were carried out the antegrade clearance to lymph nodes,and group B,43 patients with retrograde clearance to lymph nodes.The situation and prognosis of patients during or after operation were compared.Results：The average operation time,blood loss and the average number of lymph node dissection between the two groups were no significant difference.Patients with liver metastasis：antegrade group 6cases（14.0%）,retrograde group 14cases（32.6%）（P〈0 05）.The 5-year survival rates were 72.1% and 46.5%,respectively.The differences were statistically significant（P〈0.05）.Conclusion：The retrograde clearance to lymph nodes is a relatively safe surgical procedure and can reduce the incidence of liver metastasis and improve patient life quality.