结肠癌患者实施完整结肠系膜切除与传统术式的疗效比较

Effects of complete mesocolic excision and traditional operation in colon cancer

目的探讨结肠癌患者实施完整结肠系膜切除术(CME)与传统术式的疗效比较。方法选取结肠癌患者80例,将接受CME治疗患者32例作为观察组,接受传统结肠癌根治术治疗患者48例作为对照组,对两组患者的手术、预后情况、肿瘤分期及临床指标间的关系进行对比分析。结果观察组淋巴结清扫数目多于对照组,术中出血量显著少于对照组,差异均具有统计学意义(P﹤0.05,P﹤0.001);观察组Ⅲ期结肠癌的淋巴结清扫数量及阳性淋巴结数量明显多于对照组,差异具有统计学意义(P﹤0.01);两组排气、排便时间比较差异无统计学意义(P﹥0.05);观察组并发症总发生率为18.78%低于对照组的29.16%,30 d再次入院患者例数少于对照组,但差异均无统计学意义(P﹥0.05)。肿瘤复发与淋巴结清扫数量、肿瘤分期密切相关,具有统计学意义(P﹤0.05)。结论CME治疗安全、有效,并具有良好的预后,可能更适用于Ⅲ期结肠癌患者。

Objective To analyze the effects of complete mesocolic excision （CME） and traditional operation in the treatment of colon cancer. Method 80 patients with colon cancer were enrolled in the study, in which 48 cases who re-ceived traditional operation were included as control group, and 32 cases that received CME were the study group. The correlation among operation, prognosis, tumor stages and clinical measures were investigated. Result More resected lymph nodes, and less intraoperative blood loss were observed in study group as compared with control group （P〈0.05, P〈0.001）;the number of resected lymph nodes and positive lymph nodes in stage III patients in study group was signifi-cantly more than that of control group （P〈0.01）;and there were no differences in respect of time to evacuation and defeca-tion between the two groups （P〉0.05）;the incidence of complications was 18.78%in study group, which was lower than that of control group at 29.16%, and the number of re-hospitalizations in 30 d of study group was less than that of control group, though no statistically significance was observed （both P〉0.05）. A close relationship was observed among tumor relapse, number of resected lymph nodes, and tumor stages （P〈0.05）. Conclusion CME is fairly safe and effective, with good prognosis, and it may be more suitable for colon cancer at stage III.