“翻页式”完全中线入路完整肠系膜切除术在右半结肠癌患者的价值分析  

The clinical value of laparoscopic"page-turning"complete mesocolic excision for right hemicolon cancer

作　　者：江雪峰[1] 梁志宏[1] 刘书强[1] 吴秋美 Jiang Xuefeng;Liang Zhihong;Liu Shuqiang;Wu Qiumei(Department of General surgery,Zhongshan Xiaolin people’s Hospital,Guangdong 528400,China;Department of Obstetrics and gynaecology,Zhongshan Xiaolin people’s Hospital,Guangdong 528400,China)

机构地区：[1]广东省中山市小榄人民医院普通外科,528400 [2]广东省中山市小榄人民医院妇产科,528400

出　　处：《中华普外科手术学杂志（电子版）》2021年第3期279-282,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：2018年度广东省医学科学研究重点课题计划(20180021)。

摘　　要：目的探究腹腔镜下“翻页式”完全中线入路(CMA)完整肠系膜切除术在右半结肠癌患者的临床价值。方法回顾性分析2010年6月至2019年5月68例右半结肠癌患者的临床资料,根据手术入路不同分为联合中线入路HMA组(n=30)和“翻页式”组(n=38)。采用统计软件SPSS 21.0进行分析,围手术指标等计量资料采用(x±s)表示,行独立t检验;并发症等计数资料行χ^(2)检验;Kaplan-Meier法绘制两组3年无病生存率(DFS)及总生存率(OS)曲线图行生存分析,以P<0.05为差异有统计学意义。结果与HMA组比,“翻页式”组患者手术时间更短、术中出血量更少,清扫淋巴结数目较多(P<0.05);两组患者术后并发症发生率差异无统计学意义(P>0.05);两组术后3年DFS(76.7%vs.73.7%)及OS(83.3%vs.81.6%)差异无统计学意义(P>0.05)。结论“翻页式”CMA术更符合无瘤操作原则,手术时间短,术中出血量少,清扫淋巴结范围更广,具有良好的临床应用价值。Objective To observe the clinical outcome of laparoscopic page-turning complete mesocolic excision for patients with right hemicolon cancers.Methods From June 2010 to May 2019,clinical data of 68 patients with right hemicolon cancers were analyzed retrospectively.According to different surgical approaches,the patients were divided into the hybrid medial approach(HMA)group(n=30)and the"page-turning"complete medial approach(CMA)group(n=38).Statistical analysis were performed by using SPSS 21.0 software.Measurement data,such as perioperative indicators and other measurement data were expressed as (x±s),and were examined by using independent test.Count data such as complications were examined by using chi square test.Kaplan-meier method were used for analysis of the 3-year disease-free survival(DFS)and overall survival(OS).A P value of<0.05 was considered as statistically significant difference.Results(1)Compared with the HMA group,patients in the CMA group had shorter operation time,less intraoperative blood loss,and more harvested lymph nodes(P<0.05).(2)There was no significant difference between 2 groups in terms of incidence of postoperative complications(P>0.05).(3)There was no significant difference in terms of DFS(76.7%vs.73.7%)or OS(83.3%vs.81.6%)between the two groups 3 years after surgery(P>0.05).Conclusion The"Page-turning"CMA is more in line with the principle of tumor-free operation,with shorter operation time,less intraoperative blood loss and extended lymph node dissection,which has good clinical application value.

关 键 词：结肠肿瘤 腹腔镜 全结肠系膜切除术 中间入路 手术后并发症 

分 类 号：R73[医药卫生—肿瘤]