结直肠癌患者淋巴结清扫对手术疗效的影响

The effect of colorectal cancer patients surgery with lymph node dissection

目的研究淋巴结清扫对结直肠癌术后疗效的影响。方法 2009年4月至2014年4月间来本院就诊的结直肠癌患者96例,均无其他严重并发症。其中结肠癌46例,直肠癌50例。对所有患者的结直肠癌进行微创手术切除,根据患者具体情况、征求患者及家属意见的情况下决定是否对患者进行淋巴结清扫,并分为三组,每组32例。第1组是在手术中对淋巴结不进行清扫的患者,第2组是手术中清扫淋巴结为6枚以下的患者,第3组是手术中清扫淋巴结超过6枚以上的患者。制作患者手术情况调查表,对各组患者的手术时间,术中出血量,出院时间,术后1年、3年和5年复发转移情况进行统计。结果三组患者的手术时间和住院时间差异无统计学意义(P>0.05);术中出血量随着清扫淋巴结的增加也有所增加,三组患者间术中出血量比较差异显著(P<0.001);并发症以清扫淋巴结最多的第3组最多,三组患者的术后并发症比较差异显著(P<0.05),三组患者的1年、3年和5年复发转移率比较差异显著(P<0.05)。结论淋巴结清扫有利于控制结直肠癌术后复发和转移。

Objective To study the effect on lymph node dissection in colorectal cancer after curative effect.Methods Between April 2009 to April 2014,96 patients with colorectal cancer were included in this study.Which including 46 cases of colon cancer and 50 cases of rectal cancer. All patients had no other serious complications and were analyzed retrospectively, based on the specific circumstances of the patient, in the case to seek the views of patients and their families to determine whether lymph node dissection for patients divided into three groups, Group 1 was in surgery for patients with lymph node dissection is not performed, the patient cases number of 32 cases, group 2 lymph node dissection surgery in patients 6 below, the first three groups of lymph node dissection surgery in patients over more than six. For all patients with colorectal cancer minimally invasive surgery, and the second group and the third group of patients with lymph node dissection. Production surgery patients questionnaire, for each group of patients operative time, blood loss, hospital time, after 1 year, 3 years and 5 years relapse metastasis statistics. Results The number of cases among the three groups of patients, gender,degree of differentiation of colorectal cancer formation and composition of the same TNM stage, male patients than female patients, male patients of 54 cases, 42 cases of female patients. All patients with colorectal cancer patients up to the degree of differentiation, for 81 cases. The operative time and hospital stay of three groups of patients,although slightly different, but the differences among the three groups was not significant（P 〉0.05）, while the blood loss with increase in the lymph nodes also increased, the difference between the three groups of patients the blood loss was significantly（P 〈0.001）. Complications in lymph nodes up to a maximum of the first three groups,three groups of postoperative complications in patients with differences significant（P =0.05）, but the first three groups of patients a year, the lowest rate of recurrence within 3 years and 5 years, and other differences between the two groups of patients was significantly（P 〈0.05）, Conclusion Lymph node dissection help control the situation in colorectal cancer recurrence and metastasis.