Ⅲ期右半结肠癌行腹腔镜完整结肠系膜切除术与D_(3)根治术的远期疗效对比  

Long-term effect comparison of laparoscopic complete mesocolic excision and D_(3) radical resection for stage Ⅲright colon cancer

作　　者：罗威[1] 宋彦伟[1] 孙胜[1] 张艳辉[1] 邓小强[1] 何岩 李红伟[1] LUO Wei;SONG Yan-wei;SUN Sheng;ZHANG Yan-hui;DENG Xiao-qiang;HE Yan;LI Hong-wei(Department of General Surgery,Luohe Central Hospital,The 1st Affiliated Hospital of Luohe Medical College,Luohe 462000,China)

机构地区：[1]河南省漯河市中心医院漯河医学高等专科学校第一附属医院普通外科,河南漯河462000

出　　处：《中国现代普通外科进展》2021年第7期522-526,共5页Chinese Journal of Current Advances in General Surgery

基　　金：河南省医学科技攻关计划项目(201204146);漯河医学高等专科学校2015年度临床医学研究项目(2015-S-LMC20)。

摘　　要：目的:比较Ⅲ期右半结肠癌患者行腹腔镜完整结肠系膜切除术(CME)与D_(3)根治术的远期疗效。方法:回顾性分析2014年1月—2015年10月收治的102例Ⅲ期右半结肠癌患者的临床资料,其中CME手术50例,D_(3)根治手术52例。比较两组手术指标(手术时间、出血量、输血量、淋巴结清除数及结肠系膜根部淋巴结转移率、术后排气排便时间、并发症发生率、死亡率、住院天数)及两组1、3、5年生存率。结果:CME组淋巴结清除数及结肠系膜根部淋巴结转移率明显优于D_(3)组(P<0.05),而两组1、3、5年生存率差异无统计学意义(P>0.05)。结论:腹腔镜下CME和D_(3)根治术治疗Ⅲ期右半结肠癌的远期疗效相近。下一步笔者将对CME+D_(3)手术进一步研究,以期成为Ⅲ期右半结肠癌手术新的研究方向。Objective: To compare the long-term efficacy of laparoscopic complete mesocolic excision(CME) and D_(3) radical resection for stage Ⅲ right colon cancer. Methods: The clinical data of 102 patients with stage Ⅲ right colon cancer treated in our department from January 2014 to October2015 were retrospectively analyzed, including 50 cases underwent laparoscopic CME operation and 52 cases underwent laparoscopic D_(3) radical operation. The operation indexes(average operation time, bleeding volume, blood transfusion volume, number of lymph node dissection, lymph node metastasis rate of mesocolon root, exhaust and defecation time, incidence of complications, mortality,hospitalization days) and 1,3,5-year survival rates of the two groups were compared. Results:The results showed that the number of lymph node dissection and the rate of lymph node metastasis in CME group were significantly better than the D_(3) group(P<0.05), but the 1,3,5-year survival rates of the two groups had no significant difference(P>0.05). Conclusion: The long-term effects of laparoscopic CME and D_(3) radical resection are similar. In the next step, the author will further research on CME plus D_(3) operation, hoping to become a new research direction for stage Ⅲ right colon cancer surgery.

关 键 词：结肠肿瘤 腹腔镜检查 完整结肠系膜切除术 D3根治术 

分 类 号：R735.35[医药卫生—肿瘤] R656.9[医药卫生—临床医学]