CME治疗右半结肠癌效果及安全性分析  

Analysis of the safety and application value for the CME treatment in the patients of right colon cancer

作　　者：高一飞 穆向明 蒋浩海 黄平[2] 

机构地区：[1]江苏省盐城市第一人民医院普通外科,224006 [2]江苏省人民医院结直肠肛门外科,210029

出　　处：《中华普外科手术学杂志（电子版）》2017年第5期432-434,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨完整肠系膜切除术(CME)治疗右半结肠癌的效果及安全性。方法选取2009年1月至2014年12月实施手术治疗的右半结肠癌患者119例进行回顾性分析,根据手术方法分为CME组67例、传统手术组52例,数据分析采用SPSS16.0进行处理,术中术后等计量指标均采用均数±标准差进行统计描述,采用t检验;术后3年生存率、局部复发率、远处转移率、并发症率的比较采用χ2检验;P值<0.05表示差异具有统计学意义。结果两组患者的手术时间、切口长度、肛门排气时间、排便时间、住院时间比较差异无统计学意义(P>0.05),CME组的出血量、术中输血量均低于传统手术组(P<0.05);CME组患者的清扫淋巴结数目、阳性淋巴结数目、标本切除长度均高于传统手术组(P<0.05);两组患者的切缘阳性率差异无统计学意义(P>0.05);CME组患者的局部复发率10.5%、远处转移率6.0%均低于传统手术组的30.8%、17.3%(P<0.05),CME组的3年生存率86.6%高于传统组的69.2%(P<0.05)。结论 CME治疗右半结肠癌根治效果较好,对患者的远期预后有利。Objective To explore the Complete mesorectal excision （CME）effect and complications of the treatment of right colon cancer . Methods The 119 patients with right colon cancer who underwent surgical treatment in our hospital from January 2009 to December 2014 were retrospectively analyzed. According to the surgical method, 67 cases were treated by CME group, 52 cases were treated by traditional operation.Statistical analysis were performed by using SPSS 16.0 software, intraoperative and postoperative were presented as and examined by using t test ;The 3-year survival rate, local recurrence rate, distant metastasis rate and complication rate were compared with χ2 test.P 〈0.05 indicateed that the difference was statistically significant. Results There were No significant diffence in the operation time , incision length, anal exhaust time, defecation time, hospitalization timebetween the two groups （ P 〉0.05 ）. The intraoperative bleeding, blood transfusion rate in the CME group was lower than the traditional group （P 〈0.05）;The lymph node dissection, the number of positive lymph nodes ;the number of specimens and resection length in CME group were higher than those of the traditional group （P 〈0.05）;there were no significant in diffence in the margin positive rate between the two groups （P 〉0.05）;the local recurrence rate in CME group （10.5%） and distant metastasis rate（6.0%） was lower than that of the traditional group （ 30.8%, 17.3%） （P 〈0.05）, the 3 years survival rate（86.6%） in CME group was higher than that of the traditional group（69.2%） （P 〈0.05）. Conclusion Treatment of right colon cancer curative effect is good, beneficial to the long-term prognosis of patients.

关 键 词：结肠肿瘤 结肠系膜 手术中并发症 

分 类 号：R735.35[医药卫生—肿瘤]