完整结肠系膜切除术在Ⅲ期结肠癌术中的应用效果  

Application of complete mesocolic excision in stage Ⅲ colon cancer

作　　者：王强[1] 江川[1] 顾伟青[1] 

机构地区：[1]福建医科大学附属闽东医院肿瘤科,福建福安355000

出　　处：《中华胃肠外科杂志》2014年第12期1208-1211,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：福建省宁德市指导性科技计划基金项目（20130213）

摘　　要：目的：探讨完整结肠系膜切除（CME）在Ⅲ期结肠癌患者手术治疗中的应用效果。方法回顾性分析2011年7月至2013年7月间福建医科大学附属闽东医院收治的100例Ⅲ期结肠癌住院患者的临床资料。其中2012年5月以后收治的患者54例行CME手术治疗（CME组），在此之前收治的46例行传统根治术治疗组（对照组），比较两组患者淋巴结清扫情况、术后标本质量及近期临床疗效。结果 CME组淋巴结清扫总数和阳性淋巴结数目分别为（26．7±2．6）枚和（4．3±1．4）枚，均明显多于对照组的（22．9±3．7）枚和（2．8±1．2）枚（均P＜0．01）。 CME组和对照组分别有45例（83．3％）和29例（63．0％）手术标本达到C级以上，差异亦有统计学意义（P＜0．05）。两组术后并发症发生率均为13．0％（7／54和6／46），差异无统计学意义（P＞0．05）。结论 CME应用于Ⅲ期结肠癌患者安全有效，在提高了手术标本质量和淋巴结清扫数量的同时，并未增加手术并发症发生率。Objective To evaluate the efficacy of complete mesocolic excision （CME） for stageⅢ colon cancer. Methods Clinical data of 100 patients diagnosed as stage Ⅲ colon cancer in our hospital from July 2011 to July 2013 were analyzed retrospectively. Fifty-four patients in CME group underwent complete mesocolic excision and 46 patients in control group underwent traditional radical surgery. Lymphadenectomy, postoperative specimen quality and short-term clinical efficacy were compared between two groups. Results The number of gross dissected lymph nodes and positive dissected lymph nodes in CME group were 26.7±2.6 and 4.3±1.4, which were significantly higher than those in control group （22.9 ±3.7 and 2.8 ±1.2） （all P〈0.01）. There was statistical significance in surgical C-class specimens of CME group were found in 45 cases （83.3%）, which were significantly higher than those of control group （29 cases, 63.0%）（P〈0.05）. The postoperative complication rate of two groups was the same without significant difference （both 13.0%, P〉0.05）. Conclusion CME is safe and effective for stage Ⅲ colon cancer, which can improve the quality of surgical specimen and increase the number of dissected lymph nodes , but do not elevate the morbidity of postoperative complication.

关 键 词：结肠肿瘤 Ⅲ期 完整结肠系膜切除术 手术标本 淋巴结清扫 

分 类 号：R735.35[医药卫生—肿瘤]