腹腔镜下肠系膜上动脉为导向的CME在右半结肠癌中的临床应用价值  

Clinical Value of Laparoscopic Superior Mesenteric Artery-guided CME in Right Colon Cancer

作　　者：孙杨安[1] 邹俊[1] 吴昆[1] 饶华民[1] 吴亮高[1] SUN Yang’an;ZOU Jun;WU Kun;RAO Huamin;WU Lianggao(Jiangxi Cancer Hospital,Nanchang 330000,China;不详)

机构地区：[1]江西省肿瘤医院,江西南昌330000

出　　处：《中国医学创新》2022年第31期71-74,共4页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202130743)。

摘　　要：目的:探讨腹腔镜下肠系膜上动脉为导向的全结肠系膜切除术(complete mesocolic excision,CME)在右半结肠癌中的临床应用价值。方法:回顾性选取2017年10月-2018年10月江西省肿瘤医院腹部外科临床确诊的右半结肠原发腺癌患者60例,均行腹腔镜下CME治疗,按照随机数字表法将其分为动脉导向组(n=30)和静脉导向组(n=30)。对两组手术指标、术后并发症发生情况、术后3年生存率进行比较。结果:动脉导向组手术时间、术后排气时间、住院时间均短于静脉导向组,术中出血量少于静脉导向组(P<0.05);动脉导向组和静脉导向组术后并发症发生率分别为6.67%、16.67%,两组比较差异无统计学意义(P>0.05)。两组总体生存率与无瘤生存率比较,差异均无统计学意义(P>0.05)。结论:腹腔镜下肠系膜上动脉为导向的CME治疗右半结肠癌,能减少术中出血量,缩短手术时间及住院时间,且不会增加并发症,值得推广。Objective:To investigate the clinical value of laparoscopic superior mesenteric artery-guided complete mesocolic excision (CME) in right colon cancer.Method:A total of 60 patients selected retrospectively who were clinically diagnosed as primary adenocarcinoma of the right hemicolon in the Department of Abdominal Surgery,Jiangxi Cancer Hospital from October 2017 to October 2018 and treated with laparoscopic CME.They were divided into an arterial guidance group (n=30) and a venous guidance group (n=30) according to the random number table method.The operation indexes,postoperative complications and postoperative 3-year survival rate of the two groups were compared.Result:The operation time,postoperative exhaust time and hospitalization time in the arterial guidance group were shorter than those in the venous guidance group,and the intraoperative bleeding volume was less than that in the venous guidance group (P<0.05).The incidence of postoperative complications in the arterial guidance group and the venous guided group was 6.67% and 16.67%,there was no significant difference between the two groups (P>0.05).There were no significant differences in overall survival rate and tumor-free survival rate between the two groups (P>0.05).Conclusion:Laparoscopic superior mesenteric artery-directed CME for right colon cancer can reduce intraoperative bleeding,shorten operative time and hospital stay,and does not increase complications,and is worth promoting.

关 键 词：右半结肠癌 腹腔镜 CME 动脉导向 静脉导向 

分 类 号：R735.35[医药卫生—肿瘤]