结肠癌手术中完整结肠系膜切除的临床应用

Clinical application of complete mesocolic excision in colorectal cancer surgical treatment

目的：探讨结肠癌手术治疗中完整结肠系膜切除的临床应用价值。方法 ：选择2011年4月—2012年4月就诊的100例结肠癌患者作为研究对象,采用随机数字表法分为观察组和对照组各50例,观察组患者接受完整结肠系膜切除术,对照组接受传统结肠癌根治术,比较两组患者的手术情况、肿瘤标志物含量、远期预后及并发症。结果：观察组患者清除淋巴结的数目多于对照组,术后腹腔引流量大于对照组,差异有统计学意义（P〈0.05）;两组术后腹腔引流持续时间、肛门排气时间、进食时间比较,差异无统计学意义（P〉0.05）;观察组患者术后血清CCSA-2、PTN、VEGF、sICAM-1的含量均明显低于对照组（P〈0.05）;观察组3年复发率16.00%,明显低于对照组的38.00%（χ^2=5.074,P〈0.05）;两组并发症比较,差异无统计学意义（24.00%vs 28.00%,χ^2=0.052,P〈0.05）。结论：完整结肠系膜切除术有助于彻底清除淋巴结、降低血清肿瘤标志物含量、预防远期复发,是结肠癌理想的手术方法。

Objective： To study the clinical application value of complete mesocolic excision in colorectal cancer surgical treatment. Methods： 100 cases patients with colon cancer in our hospital from April 2011- April 2012 during were randomly divided into observation group and control group,observation group patients received complete mesocolic excision, the control group received conventional colon cancer surgery. Then surgical condition, tumor marker contents as well as the long-term prognosis were compared between two groups. Results： Observation group lymph node dissection numbers were significantly more than the control group, intraperitoneal drainage volume were significantly more than the control group（P〈0.05）; there were no statistically difference of postopera-tive abdominal drainage duration, anal exhaust time, feeding time between two groups（P〈0.05）;Serum CCSA-2, PTN, VEGF, s ICAM-1 contents of observation group were significantly lower than the control group（P0.05）; Observation group 3-year recurrence rate were significantly lower than control group（χ^2=5.074, P0.05）; There were no statistically difference of complications between two groups（24.00% vs 28.00%, χ^2=0.052, P0.05）. Conclusion： Complete mesenteric resection is helpful to completely eliminate lymph nodes, decrease serum tumor marker contents, prevent long-term relapse; it＇s an ideal surgical method for colon cancer.