完整结肠系膜切除术治疗结肠癌患者疗效和预后分析

Effect analysis of mesocolon complete resection on patients with colon cancer

目的在结肠癌的治疗中,外科手术是临床通常采用的方法,如传统根治术和完整结肠系膜切除术等。本研究对比分析完整结肠系膜切除术和传统根治术对结肠癌患者近期疗效和预后的影响。方法选取聊城市东昌府人民医院2011-05-01-2013-05-31收治的结肠癌患者80例,其中40例患者接受完整结肠系膜切除术(CME组),40例患者接受传统根治手术(传统组),对两组患者的近期疗效、淋巴结清除数目及复发率进行统计分析。结果 CME组患者的术中出血量、术后肛门排气时间、排便时间和住院时间分别为(115.1±21.4)mL、(3.1±1.0)d、(4.5±1.4)d和(11.8±3.6)d,均优于传统组,差异有统计学意义,均P值<0.05。CME组患者左半结肠淋巴结、右半结肠淋巴结、阳性转移淋巴结和平均淋巴结清除数目分别为(8.2±1.6)、(8.6±1.4)、(18.4±1.1)和(25.7±2.2)个,均优于传统组,差异有统计学意义,均P值<0.05。CME组患者的并发症发生率和复发率均为5.0%(2/40),均显著低于传统组的25.0%(10/40)和22.5%(9/40),差异有统计学意义,P<0.05;CME组患者3年生存率为92.5%(37/40),显著高于传统组的57.5%(23/40),差异有统计学意义,P<0.05。结论完整结肠系膜切除术较传统根治手术治疗结肠癌患者近期疗效好,淋巴结清除数目多,复发率低。

OBJECTIVE For the treatment of patients with colon cancer,surgery is often used.The objective of this study was to investigate the effect of complete resection of the mesocolon and the number of lymph node dissection and the recurrence rate.METHODS Totally 80 cases of patients with colon cancer who were treated in ongchangfu People＇s Hospital of Liaocheng from May 2011 to May 2013 were selected,these patients were divided into mesocolon complete resection group（CME group,n=40）and the traditional radical surgery group（traditional group,n=40）.The short-term efficacy,numbers of lymph node dissection and recurrence rate of the two groups were statistically analyzed.RESULTS The blood loss,postoperative flatus,defecation time and hospital stay time of CME group were（115.1±21.4）mL,（3.1±1.0）d,（4.5±1.4）d and（11.8±3.6）d,respectively,which were significantly better than those of traditional group（all P〈0.05）.The dissection lymph nodes numbers of left colon,right colon,positive lymph nodes and mean number of lymph node dissection of CME group were 8.2±1.6,8.6±1.4,18.4±1.1and 25.7±2.2,which were significantly more than those of traditional group（all P〈0.05）.The incidence of complications and recurrence rate of CME group were both5.0%（2/40）,which were significantly lower than those of the traditional group 25.0%（10/40）,22.5%（9/40）（P〈0.05）.The 3-year survival rates of CME group and the traditional group were 92.5%（37/40）and 57.5%（23/40）（P〈0.05）.CONCLUSION Mesocolon complete resection has better curative effect,more number of lymph node dissection,lower relapse rate than that of traditional radical surgery in the treatment of patients with colon cancer.