局解手术学杂志
跼解手術學雜誌
국해수술학잡지
JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY
2014年
3期
284-286
,共3页
完整结肠系膜切除%结肠癌%淋巴结清扫%复发率
完整結腸繫膜切除%結腸癌%淋巴結清掃%複髮率
완정결장계막절제%결장암%림파결청소%복발솔
complete mesocolic excision%colon carcinoma%lymph node scavenge%relapse
目的：探讨完整结肠系膜切除（ CME)在结肠癌患者中的应用价值。方法68例结肠癌患者按照手术方法分为CME组（n＝34)和对照组（n＝34),CME组行CME手术,对照组行传统开腹手术。观察2组手术情况、围手术期并发症、淋巴结清扫数量、复发率。结果 CME组平均手术时间（158±38) min、住院时间（13.4±4.0) d、肛门排气时间（2.3±0.5) d、术后前3 d引流量（123.3±20.5) mL、引流管拔除时间（12.3±2.5) d与对照组相比均无显著差异（P>0.05)； CME组术中出血量（112.3±35.5) mL与对照组（146.6±36.7) mL相比显著差异（P<0.05)。2组围手术期并发症发生率无显著差异（P>0.05)。 CME组TNM Ⅰ期淋巴结清扫数目（13.6±4.7)个与对照组（12.2±3.4)个相比无显著差异（P>0.05),TNM Ⅱ期（18.6±6.7)个及Ⅲ期（22.6±8.6)个均显著多于对照组（15.2±4.8)个,（16.8±6.7)个（P＝0.0190,0.0028)。 CME组术后复发率（0.0%)显著低于对照组（17.6%)（χ2＝4.5699,P＝0.0325)。结论 CME不增加结肠癌根治术的风险,且能更大范围清除淋巴结,减少肿瘤复发。
目的：探討完整結腸繫膜切除（ CME)在結腸癌患者中的應用價值。方法68例結腸癌患者按照手術方法分為CME組（n＝34)和對照組（n＝34),CME組行CME手術,對照組行傳統開腹手術。觀察2組手術情況、圍手術期併髮癥、淋巴結清掃數量、複髮率。結果 CME組平均手術時間（158±38) min、住院時間（13.4±4.0) d、肛門排氣時間（2.3±0.5) d、術後前3 d引流量（123.3±20.5) mL、引流管拔除時間（12.3±2.5) d與對照組相比均無顯著差異（P>0.05)； CME組術中齣血量（112.3±35.5) mL與對照組（146.6±36.7) mL相比顯著差異（P<0.05)。2組圍手術期併髮癥髮生率無顯著差異（P>0.05)。 CME組TNM Ⅰ期淋巴結清掃數目（13.6±4.7)箇與對照組（12.2±3.4)箇相比無顯著差異（P>0.05),TNM Ⅱ期（18.6±6.7)箇及Ⅲ期（22.6±8.6)箇均顯著多于對照組（15.2±4.8)箇,（16.8±6.7)箇（P＝0.0190,0.0028)。 CME組術後複髮率（0.0%)顯著低于對照組（17.6%)（χ2＝4.5699,P＝0.0325)。結論 CME不增加結腸癌根治術的風險,且能更大範圍清除淋巴結,減少腫瘤複髮。
목적：탐토완정결장계막절제（ CME)재결장암환자중적응용개치。방법68례결장암환자안조수술방법분위CME조（n＝34)화대조조（n＝34),CME조행CME수술,대조조행전통개복수술。관찰2조수술정황、위수술기병발증、림파결청소수량、복발솔。결과 CME조평균수술시간（158±38) min、주원시간（13.4±4.0) d、항문배기시간（2.3±0.5) d、술후전3 d인류량（123.3±20.5) mL、인류관발제시간（12.3±2.5) d여대조조상비균무현저차이（P>0.05)； CME조술중출혈량（112.3±35.5) mL여대조조（146.6±36.7) mL상비현저차이（P<0.05)。2조위수술기병발증발생솔무현저차이（P>0.05)。 CME조TNM Ⅰ기림파결청소수목（13.6±4.7)개여대조조（12.2±3.4)개상비무현저차이（P>0.05),TNM Ⅱ기（18.6±6.7)개급Ⅲ기（22.6±8.6)개균현저다우대조조（15.2±4.8)개,（16.8±6.7)개（P＝0.0190,0.0028)。 CME조술후복발솔（0.0%)현저저우대조조（17.6%)（χ2＝4.5699,P＝0.0325)。결론 CME불증가결장암근치술적풍험,차능경대범위청제림파결,감소종류복발。
Objective To explore the value of complete mesocolic excision ( CME) for patients with colon carcinoma. Methods The 68 patients with colon carcinoma were divided into CME group (n=34) and control group (n=34) randomly. The patients in CME group were managed CME and the control group were arranged traditional open operation. The operation condition, preoperative complications, a-mount of lymph node scavenged,and the relapse rate of the 2 groups were contrasted. Results The operation period,the hospital stays,period of passage of gas by anus,the drainage volume post 3 days of operation and the period of drainage tube extraction of CME group were respec-tively(158 ± 38) min,(13. 4 ± 4. 0),(2. 3 ± 0. 5) d,(123. 3 ± 20. 5) mL,(12. 3 ± 2. 5) d,with no difference compared to control group (P>0. 05). The intraoperative bleeding volume of CME group (112. 3 ± 35. 5) mL was less than that of control group (146. 6 ± 36. 7) mL (P<0. 05). There was no difference in complication and the amount of lymph nodes scavenged of patients between 2 groups(P>0. 05). But the amount of lymph nodes scavenged of patients in TNM Ⅱ and Ⅲ of CME group (18. 6 ± 6. 7),(22. 6 ± 8. 6) was more than that of control group (15. 2 ± 4. 8),(16. 8 ± 6. 7)(P=0. 019 0,0. 002 8). The relapse rate in CME group (0. 0%) was lower than that in control group (17. 6%)(χ2 =4. 569 9,P=0. 032 5). Conclusion CME will not increase the risks of radical operation for colon carcinoma,but can scavenge more lymph nodes and decrease the tumor relapse rate.
