全结肠系膜切除与传统手术对结肠癌的疗效比较

Comparison of Efficacy of Traditional Radical Resection and Complete Mesocolic Excision for Colon Cancer

目的比较结肠癌采用全结肠系膜切除术和传统手术治疗的临床疗效及安全性。方法按照随机数字表法将117例结肠癌患者分为两组,观察组行全结肠系膜切除手术,对照组行传统根治手术,比较两组的临床效果及术后并发症情况。结果两组的手术时间比较,差异无统计学意义(P>0.05),观察组术中出血量、术后引流量少于对照组、术后排气时间以及术后住院时间均短于对照组,差异均有统计学意义(P均<0.05)。观察组清扫的淋巴结、阳性淋巴结、左半结肠淋巴结以及右半结肠淋巴结数量均多于对照组,差异有统计学意义(P<0.05)。手术后两组并发症主要有吻合口出血、切口感染、腹腔残余感染以及病灶复发,经Fisher确切概率法比较,观察组腹腔残余感染、病灶复发的发生率低于对照组,差异有统计学意义(P<0.05),两组中其他并发症发生率比较差异无统计学意义(P>0.05)。结论全结肠系膜切除术治疗结肠癌具有临床疗效好,创伤小,术后腹腔残余感染率低等特点,临床有重要的参考价值。

Objective To compare the clinical efficacy and safety of complete mesocolic excision and traditional radical resection for colon cancer. Methods 117 cases of colon cancer were randomly divided into 2 groups,the observation group was treated by complete mesocolic excision,the control group received traditional radical resection,clinical efficacy and postoperative complications of the 2 groups were compared. Results There had no statistically significant difference in operation time between the 2 groups( P > 0. 05). Intraoperative bleeding volume,postoperative drainage volume,postoperative exhaust time and postoperative hospitalization time in the observation group were less than those of the control group,the difference was statistically significant( P < 0. 05). Number of lymph node dissection,positive lymph node,left half colon lymph node and right half colon lymph node in the observation group were less than those of the control group,the difference was statistically significant( P < 0. 05). After operation,the complications of the 2 groups mainly included anastomotic bleeding,incision infection,abdominal residual infection and disease recurrence. After the Fisher exact probability method,the incidence of abdominal residual infection and disease recurrence in the observation group was lower than that of the control group,the difference was statistically significant( P < 0. 05),and there had no statistically significant difference in other complications between the 2 groups( P > 0. 05). Conclusion Complete mesocolic excision in the treatment of the colon cancer is effective with small trauma,and low incidence of abdominal residual infection,it has important reference value in clinical.