CAJ | 학술논문

目的评估右侧结肠癌根治术中常规根部切断结肠中血管的远期疗效.方法将1981年1月至2004年12月间在我院行右侧结肠癌根治术的患者308例按手术的不同方法,将患者分为两组:A组(103例,1996年1月至2004年12月间),常规根部切断结肠中血管,清除结肠中血管周围组织:B组(205例,1981年1月至1995年12月间)仅切断结肠中血管右侧支;对两组患者手术的安全性和随访结果进行比较分析.结果 A组和B组手术死亡均为1.0%.吻合口瘘发生率分别为2.9%和2.4%,腹腔淋巴瘘发生率分别为8.7%和5.9%,胃潴留发生率分别为9.7%和5.9%,其他并发症发生率分别为4.9%和3.9%;两组比较,差异均无统计学意义(P>0.05).254例(82.5%)获得随访,随访时间8～60个月.A组1、3年复发率分别为1.9%和13.6%,B组则分别为19.0%和24.9%,两组比较,差异有统计学意义(P<0.05).5年生存率A组为(78.3±3.4)%;B组为(64.8±2.8)%;两组比较,差异也有统计学意义(P<0.05).结论右侧结肠癌根治术中,常规根部切断结肠中血管,不增加手术并发症,可明显减少术后1、3年复发率,提高5年生存率.
목적 평고우측결장암근치술중상규근부절단결장중혈관적원기료효.방법 장1981년1월지2004년12월간재아원행우측결장암근치술적환자308례안수술적불동방법,장환자분위량조:A조(103례,1996년1월지2004년12월간),상규근부절단결장중혈관,청제결장중혈관주위조직:B조(205례,1981년1월지1995년12월간)부절단결장중혈관우측지;대량조환자수술적안전성화수방결과진행비교분석.결과 A조화B조수술사망균위1.0%.문합구루발생솔분별위2.9%화2.4%,복강림파루발생솔분별위8.7%화5.9%,위저류발생솔분별위9.7%화5.9%,기타병발증발생솔분별위4.9%화3.9%;량조비교,차이균무통계학의의(P>0.05).254례(82.5%)획득수방,수방시간8～60개월.A조1、3년복발솔분별위1.9%화13.6%,B조칙분별위19.0%화24.9%,량조비교,차이유통계학의의(P<0.05).5년생존솔A조위(78.3±3.4)%;B조위(64.8±2.8)%;량조비교,차이야유통계학의의(P<0.05).결론 우측결장암근치술중,상규근부절단결장중혈관,불증가수술병발증,가명현감소술후1、3년복발솔,제고5년생존솔.
Objective To compare the long-term outcome of ligating the middle colic artery in radical surgical treatment of right hemicolon cancer. Methods The operation safety, complications and short-term outcome between two groups of patients undergone either ligating the middle colic artery from its root (A group) or ligating the middle colic artery from its right branch (B group) in right bemicolectomy for colon cancer. Results Between January 1981 and December 2004, 308 patients underwent radical right hemicolectomy in which 103 patients were treated by ligating the middle colic artery from its roots (Jan. 1996 to Dec. 2004, A group), and 205 patients via ligating the middle colic artery from the roots of its right branch (Jan. 1981 to Dec. 1995, B group). The complications were compared between the two groups (P>0.05). The mean follow-up time of A and B group were (50.1±7.2) months and (49.1±7.2) months respectively. Local recurrences of 1-year, 3-year and cumulative survival probability at the 60th month in group A were 1.9%, 13.6% and (78.3±3.4)% respectively, which were significantly better than 19.0%, 24.9% and (64.8±2.8)% in group B (P<0.05). Conclusion Ligating the middle colic artery from its root in right hemicolectomy can be performed safely and effectively, which is to be highly recommended in curative resection of right colon.