完整结肠系膜切除在右半结肠癌手术中的应用探讨

Study on Application of Complete Mesocolic Excision in the Right-side Colon Cancer Surgery

目的对在右半结肠癌手术中完整结肠系膜切除术的临床效果进行分析和探讨。方法方便选择2012年6月—2014年6月期间由于右半结肠癌而在该院治疗的60例患者作为研究对象,通过随机的方式对这些患者进行划分,其中30例为对照组,30例为观察组。采用传统根治术治疗对照组患者,采用完整结肠癌系膜切除术治疗观察组患者,对两组患者的相关手术指标、并发症发生率等进行比较,同时对其进行为期2年的随访,对两组患者的复发率和死亡率等进行统计和比较。结果观察组的术中出血量为(178.27±12.43)m L、术后引流量为(58.43±2.49)m L、淋巴结清扫总数目为(21.03±1.29)个,对照组的术中出血量为(231.42±13.61)m L、术后引流量为(84.21±1.74)m L、淋巴结清扫总数目为(12.97±1.58)个;观察组的残端肿瘤残余率为3.3%、术后吻合口漏率为0.0%、并发症发生率6.7%、死亡率0.0%、复发率为3.3%,对照组的残端肿瘤残余率为6.7%、术后吻合口漏率为3.3%、并发症发生率20.0%、死亡率10.0%、复发率为13.3%。在上述指标方面,观察组与对照组相比差异有统计学意义(P<0.05)。结论在右半结肠癌的临床治疗中采用完整结肠系膜切除的方式具有十分显著的效果,能够将患者的肿瘤有效清除,并且具有较低的复发率和死亡率。

Objective To analyze and observe the clinical effect of complete mesocolic excision in the right-side colon cancer surgery. Methods Convenient selection 60 cases of patients with right-side colon cancer surgery admitted and treated during June 2012 to June 2014 in our hospital were selected and randomly divided into two groups with 30 cases in each,the control group were treated with traditional radical surgery, while the observation group were treated with complete mesocolic excision, and the related operative index and incidence rate of complications were compared between the two groups,and the recurrence rate and death rate were counted and compared through 2-year follow-up. Results The intraoperative bleeding amount, postoperative drainage amount and total number of lymph node dissection in the observation group and the in the control group were respectively（178.27±12.43）mL,（58.43±2.49）mL,（21.03±1.29）and（231.42±13.61）mL,（84.21±1.74）mL,（12.97±1.58）,and the residual rate of stump tumor, anastomotic leak after operation, incidence rate of complications, death rate and recurrence rate in the observation group and in the control group were respectively 3.3%, 0.0%, 6.7%,0.0%, 3.3% and 6.7%, 3.3%, 20.0%, 10.0% and 13.3%, and there were obvious differences between the two groups by comparison（P〈0.05）. Conclusion The effect of complete mesocolic excision in the clinical treatment of right-side colon cancer surgery is very obvious, which can effectively clear the tumors of patients with lower recurrence rate and death rate.