腹腔镜辅助与开腹全结肠系膜切除术治疗老年人右半结肠癌疗效和安全性的比较  

Comparison of efficacy and safety between laparoscopic assisted and open total mesorectal excision in the treatment of right colon cancer in the elderly

作　　者：崔勇[1] 程树杰[2] 张燕北 王乾[4] 霍然[5] 

机构地区：[1]河北大学附属医院肿瘤外科,保定071000 [2]河北大学附属医院普外科,保定071000 [3]保定市第一医院直肠外科,071000 [4]保定市第一医院儿科,071000 [5]河北大学附属医院肿瘤内科,保定071000

出　　处：《武警医学》2017年第11期1100-1103,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：河北省政府资助临床医学优秀人才培养项目(361007)

摘　　要：目的分析比较腹腔镜辅助全结肠系膜切除(laparoscopy-assisted complete mesocolic excision,LCME)与开腹全结肠系膜切除(open complete mesocolic excision,OCME)治疗老年人右半结肠癌的可行性、安全性及临床疗效观察。方法回顾性分析河北大学附属医院2011-04至2015-09收治的老年右半结肠癌170例的临床资料,其中LCME组和OCME组各85例,比较两组患者的术中、术后临床资料及随访资料。结果两组患者的术中出血量、初次排气时间、初次进流食时间、平均住院时间,LCME组患者明显少于OCME组,差异有统计学意义(均P<0.05)。两组患者手术质量分级、手术时间、清扫淋巴结数目、术后心脑血管意外发生率及未见统计学差异(均P>0.05)。术后随访时间为48个月,两组患者的复发率和转移率差异无统计学意义。结论腹腔镜辅助全结肠系膜切除术(LCME)治疗老年患者右半结肠癌的安全性、可行性、根治性,以及短期生存均不逊于传统开腹手术。Objective To evaluate the safety and feasibility of laparoscopic-assisted CME （laparoscopic complete mesocolic ex- cision, LCME） and open CME （open complete mesocolic excision, OCME） in the treatment of elderly patients with fight colon cancer. Methods Data was collected retrospectively by reviewing the medical records of 170 patients of right-sided colon cancer who had underg- one right colectomy in the Affiliated Hospital of Hebei University between April 2011 and September 2015. The elderly patients were e- qually divided into LCME group and OCME group based on the approach to coleetomy. Demographic variables including age, gender, in- formation on surgery,pathological findings and follow-up were collected and analyzed. Results The median blood loss, median time to a- nal exhaust, post-operative liquid food, and hospital stay were significantly shorter or lower in LCME group than those in OCME group （P 〈 0.05 ）. The difference of durations of surgery, operation quality grading,cardiac-cerebrovascular accidents, tumor diameter and the number of harvested lymph nodes were not statistically significant between the two groups （P 〉 0.05 ）. After follow-up of 48 months, the rate of local recurrence and distant metastasis showed no significant difference between the two groups （P 〉 0.05）. Conclusions LCME is a safe and feasible treatment for elderly patients with right colon cancer. It can facilitate the recovery of postoperative patients.

关 键 词：结肠肿瘤 全结肠系膜切除术 腹腔镜手术 右半结肠切除术 手术质量分级 老年患者 

分 类 号：R735.35[医药卫生—肿瘤]