腹腔镜下完整肠系膜切除术与传统结肠癌根治术治疗中青年及老年Ⅲ期结肠癌的效果比较

Comparison of the effect of laparoscopic complete mesocolic resection and traditional radical colectomy in the treatment of young and middle-aged and elderly aged patients with stage Ⅲ colon cancer

目的探讨腹腔镜下完整肠系膜切除术与传统结肠癌根治术治疗中青年及老年Ⅲ期结肠癌的效果比较。方法选取2013年1月至2016年6月治疗的Ⅲ期结肠癌患者153例进行回顾性分析,根据手术术式的不同分为完整肠系膜切除术(CME)组(78例,中青年34例、老年44例)和传统组(75例,中青年37例、老年38例),CME组采用腹腔镜下完整肠系膜切除术,传统组采用传统结肠癌根治术。应用SPSS 17.0统计学软件进行统计学处理,术中、术后相关指标和淋巴结清扫情况以(x珋±s)表示,采用独立t检验;术后并发症的发生率采用卡方检验,以P<0.05差异具有统计学意义。结果两组患者中不同年龄段(中青年和老年)患者的术中、术后相关指标、淋巴结清扫情况和术后并发症进行组内比较,差异均无统计学意义(P>0.05);与传统组相比,CME组中青年和老年患者的术中出血量显著降低(P<0.05),手术时间、术后排气时间、留置引流管时间和住院时间均显著缩短(P<0.05);与传统组相比,CEM组中青年和老年患者的淋巴结清扫数、左、右结肠淋巴结和淋巴结阳性转移数均显著增加(P<0.05);传统组的术后并发症的总发生率为8例(10.7%),CME组为2例(2.6%),差异具有统计学意义(P<0.05)。结论腹腔镜下完整肠系膜切除术治疗中青年和老年Ⅲ期结肠癌的临床效果较好,术中出血量少、术后恢复快,且安全性较高。

Objective To compare the effect between laparoscopic complete mesocolic resection and traditional radical eolectomy in the treatment of young and middle-aged and elderly aged patients with stage Ⅲ colon cancer. Methods 153 patients with stage colon cancer were collected in our hospital from January 2013 to June 2016 and analyzed retrospectively. The patients were divided into the CME group （78 cases, with 34 cases of young and middle-aged patients, and 44 cases of elderly patients, who received laparoscopic complete mesocolic resection） and the traditional group （75 cases, with 37 cases of young and middle-aged patients, and 38 cases of elderly patients, who received traditional radical colectomy） according to the operation method. Statistical analysis was performed by using SPSS 17.0 software, intraoperative and postoperative indicators and conditions of lymph node dissected were presented as （ X ＋ s ） and examined by using t test ; the incidence of postoperative complications were presented as [ n （ % ）] and examined by chi square test. A P value of 〈 0.05 was considered as significant difference. Results There was no significant difference of intraoperative and postoperative related indicates, lymph node dissection and postoperative complications among the different aged patients （young and middle-aged and elderly patients） in both of the two groups （P 〉 0.05 ） ; Compared with the traditional group, the operative blood loss of young and middle-aged and elderly patients in CME group was significantly reduced, and the operative time, postoperative exhaust time, drainage time and hospitalization time were significantly shortened （ P 〈 0. 05 ）. Compared with the traditional group, the number of lymph node dissected, lymph node in left and right colon, number of positive lymph node metastases of young and middle-aged and elderly patients in CME group were increased significantly （ P 〈 0.05 ）. The total incidence of postoperative complications in the traditional group was 8 （ 10.7% ）, and in the CME group was 2 （ 2. 6% ）, and the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Laparoscopic complete mesocolic resection is effective in the treatment of young and middle-aged and elderly patients with stage Ⅲ colon cancer, with less blood loss, faster postoperative recovery and higher safety.