腹腔镜右半结肠癌根治术中完整结肠系膜切除的应用  

The effect of complete mesocolic excision in the operation of right colon cancer under laparoscope

作　　者：殷放[1] 翁泽滨[1] 岑宏[1] 汤聪[1] 

机构地区：[1]中山大学附属第五医院普外科,珠海519000

出　　处：《中华腔镜外科杂志（电子版）》2015年第3期19-22,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：卫生部医药卫生科技发展基金课题(W2013R16)

摘　　要：目的探讨腹腔镜右半结肠癌根治性切除手术中完整结肠系膜切除(CME)的应用效果。方法回顾性分析2010年1月至2014年12月中山大学附属第五医院收治的267例结肠癌根治性切除手术患者的临床资料。将患者分为两组:开腹手术组与腹腔镜组,其中开腹手术组192例,腹腔镜组75例。两组患者均行CME,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。结果腹腔镜组淋巴结清扫总数和阳性淋巴结数目分别为(23.6±5.8)枚和(6.2±4.7)枚,均明显多于开腹手术组的(17.5±4.6)枚和(4.2±2.5)枚(均P<0.01)。腹腔镜组和开腹手术组分别有71例(94.67%)和158例(82.29%)手术标本达到C级以上,差异有统计学意义(P<0.05)。两组术后并发症发生率分别为16.5%和15.8%,差异无统计学意义(P>0.05)。结论腹腔镜右半结肠癌手术中CME的应用可以提高手术标本质量和淋巴结清扫数量并且未增加手术并发症的发生率。Objective To evaluate the efficacy of complete mesocolic excision（ CME） in the operation of right colon cancer under laparoscope. Methods Clinical data of 267 patients of right colon cancer in our hospital from Jan. 2010 to Dec. 2014 were analyzed retrospectively. 192 patients in CME under traditional operation,75 patients in CME under laparoscope. Lymphadenectomy, postoperative specimen quality and short-term clinical efficacy were compared between two groups. Results The number of gross dissected lymph nodes and positive lymph nodes in laparoscope group were（ 23. 6 ± 5. 8） and（ 6. 2 ± 4. 7）,which is significantly higher than control group,which is（ 17. 5 ± 4. 6） and（ 4. 2 ± 2. 5）（ P 0. 01）,There is statistical significance surgical C-class specimens were found in 71 cases（ 94. 67%）which is significantly higher than that of control group 158 cases（ 82. 29%）（ P 0. 05）. The postoperative complication rate of two groups have not significant difference（ 16. 5% vs 15. 8%,P 0. 05）. Conclusions CME under the laparoscope is safe and effective for right colon cancer,it 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：完整结肠系膜切除 腹腔镜 右半结肠癌 

分 类 号：R735.35[医药卫生—肿瘤]