完整结肠系膜切除术与传统根治术治疗结肠癌对患者生存期的影响观察  

Effect of complete mesocolectomy and traditional radical resection on survival of patients with colon cancer

作　　者：张聃[1] 王毅 冯文迪 方兴中 Zhang Dan;Wang Yi;Feng Wendi;Fang Xingzhong(Department of Gastrointestinal Hernia Surgery,The First People’s Hospital of Chengdu,Chengdu Sichuan Province 610000,China;Surgical Anesthesia Center,The First People’s Hospital of Chengdu,Chengdu Sichuan Province 610000,China;Department of General Surgery,The First People’s Hospital of Lanzhou,Lanzhou Gansu Province 730050,China)

机构地区：[1]成都市第一人民医院胃肠疝外科,成都610000 [2]成都市第一人民医院手术麻醉中心,成都610000 [3]兰州市第一人民医院普外科,兰州730050

出　　处：《中华普外科手术学杂志（电子版）》2024年第3期279-282,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省卫生健康委员会科研课题(20PJ195);兰州市科学技术局科技发展指导性计划项目(2022-ZD-7)。

摘　　要：目的分析腹腔镜下完整结肠系膜切除术(CME)与传统开腹根治术治疗结肠癌对患者生存期的影响。方法回顾性分析2018年1月至2021年12月收治的104例结肠癌患者的临床资料,依据不同术式分为腔镜组(采用腹腔镜CME术式治疗)和开腹组(采用传统开腹根治术治疗),每组患者各52例。采用SPSS 25.0进行数据处理,围手术相关指标、淋巴结清扫数量等计量资料以(x±s)表示,行独立样本t检验;并发症发生率等计数资料以[例(%)]表示,采用χ^(2)检验;生存期用K-M生存曲线分析,行Log-Rank检验。检验水准α=0.05。结果腔镜组患者术中出血量、术后排气时间、术后排便时间均低于开腹组(P<0.05);腔镜组患者左半结肠淋巴结、右半结肠淋巴结及淋巴结清扫数量均多于开腹组(P<0.05);两组患者并发症发生率比较差异无统计学意义(P>0.05);腔镜组患者术后5年内生存率为63.5%(33/52),开腹组患者术后5年内生存率为50.0%(26/52);腔镜组术后中位总生存期(OS)为4.6年明显大于开腹组的3.3年(P<0.05)。结论腹腔镜下CME临床效果显著,可改善结肠癌患者手术相关指标并提高淋巴结清扫数量,有助于提高患者生存期。Objective To analyze the effects of laparoscopic complete mesocolectomy(CME)and traditional laparotomy on survival of patients with colon cancer.Methods The clinical data of 104 patients with colon cancer admitted from January 2018 to December 2021 were retrospectively analyzed,and they were divided into endoscopic group(treated with CME)and laparotomy group(treated with traditional radical surgery)according to different operation methods,with 52 patients in each group.SPSS 25.0 was used for data processing.Measurement data such as perioperative indicators and number of lymph nodes dissection were expressed as(x±s),and independent sample t test was performed.The statistical data such as the incidence of complications were shown by[cases(%)]andχ^(2)test was used.The survival period was analyzed by K-M survival curve and tested by Log-Rank.Test levelα=0.05.Results The intraoperative blood loss,postoperative exhaust time and postoperative defecation time in endoscopy group were lower than those in laparotomy group(P<0.05).The average number of left and right colon lymph nodes and lymph node dissection in endoscopy group were higher than those in laparotomy group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The 5-year survival rate was 63.5%(33/52)in the endoscopic group and 50.0%(26/52)in the laparotomy group.The median OS of the endoscopic group was 4.6 years,which was significantly higher than that of the laparotomy group(3.3 years)(P<0.05).Conclusion Laparoscopic CME has significant clinical effects,which can improve surgical indicators and increase the number of lymph node dissection in colon cancer patients,and help to improve the survival of patients.

关 键 词：结肠肿瘤 腹腔镜 完整结肠系膜切除术 剖腹术 手术后并发症 淋巴结切除术 

分 类 号：R735.35[医药卫生—肿瘤]