中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
3期
264-267
,共4页
王铁%叶颖江%韩亚妹%高志冬%郭鹏%杨晓东%姜可伟%尹慕军%王杉
王鐵%葉穎江%韓亞妹%高誌鼕%郭鵬%楊曉東%薑可偉%尹慕軍%王杉
왕철%협영강%한아매%고지동%곽붕%양효동%강가위%윤모군%왕삼
结肠肿瘤%完整结肠系膜切除术%淋巴结清扫%短期疗效
結腸腫瘤%完整結腸繫膜切除術%淋巴結清掃%短期療效
결장종류%완정결장계막절제술%림파결청소%단기료효
Colonic neoplasms%Complete mesocolic excision%Lymph node dissection%Treatment outcomes,short term
目的 探讨完整结肠系膜切除术(CME)的短期疗效.方法 回顾性分析2011年1月至2011年10月在北京大学人民医院胃肠外科接受根治术的62例Ⅰ～Ⅲ期结肠癌患者的临床资料,其中行CME者31例(CME组),行传统结肠癌根治术者31例(非CME组).结果 CME组和非CME组患者淋巴结清扫总数分别为(22.5±1.8)枚和(17.6±1.3)枚(P＜0.05);9.7％(3/31)的CME患者高位血管根部淋巴结阳性.两组术中出血量分别为(123.5±17.6) ml和(143.5±15.3) ml,差异无统计学意义(P＞0.05).除术后3d内腹腔引流量CME组明显多于非CME组(P＜0.05)外,两组术后引流管拔除时间、排气时间、进食时间等术后恢复指标以及术后住院时间、住院费用等社会经济效应指标的差异均无统计学意义(均P＞0.05).CME组术后发生肠梗阻3例,淋巴漏2例,切口裂开1例;非CME组术后发生肠梗阻4例,切口裂开1例,两组术后并发症发生率的差异无统计学意义(19.4％比16.1％,P＞0.05).结论 与传统手术相比,CME淋巴结清扫更彻底,包括系膜根部淋巴结,且不会影响术后恢复及增加术后并发症风险.
目的 探討完整結腸繫膜切除術(CME)的短期療效.方法 迴顧性分析2011年1月至2011年10月在北京大學人民醫院胃腸外科接受根治術的62例Ⅰ～Ⅲ期結腸癌患者的臨床資料,其中行CME者31例(CME組),行傳統結腸癌根治術者31例(非CME組).結果 CME組和非CME組患者淋巴結清掃總數分彆為(22.5±1.8)枚和(17.6±1.3)枚(P＜0.05);9.7％(3/31)的CME患者高位血管根部淋巴結暘性.兩組術中齣血量分彆為(123.5±17.6) ml和(143.5±15.3) ml,差異無統計學意義(P＞0.05).除術後3d內腹腔引流量CME組明顯多于非CME組(P＜0.05)外,兩組術後引流管拔除時間、排氣時間、進食時間等術後恢複指標以及術後住院時間、住院費用等社會經濟效應指標的差異均無統計學意義(均P＞0.05).CME組術後髮生腸梗阻3例,淋巴漏2例,切口裂開1例;非CME組術後髮生腸梗阻4例,切口裂開1例,兩組術後併髮癥髮生率的差異無統計學意義(19.4％比16.1％,P＞0.05).結論 與傳統手術相比,CME淋巴結清掃更徹底,包括繫膜根部淋巴結,且不會影響術後恢複及增加術後併髮癥風險.
목적 탐토완정결장계막절제술(CME)적단기료효.방법 회고성분석2011년1월지2011년10월재북경대학인민의원위장외과접수근치술적62례Ⅰ～Ⅲ기결장암환자적림상자료,기중행CME자31례(CME조),행전통결장암근치술자31례(비CME조).결과 CME조화비CME조환자림파결청소총수분별위(22.5±1.8)매화(17.6±1.3)매(P＜0.05);9.7％(3/31)적CME환자고위혈관근부림파결양성.량조술중출혈량분별위(123.5±17.6) ml화(143.5±15.3) ml,차이무통계학의의(P＞0.05).제술후3d내복강인류량CME조명현다우비CME조(P＜0.05)외,량조술후인류관발제시간、배기시간、진식시간등술후회복지표이급술후주원시간、주원비용등사회경제효응지표적차이균무통계학의의(균P＞0.05).CME조술후발생장경조3례,림파루2례,절구렬개1례;비CME조술후발생장경조4례,절구렬개1례,량조술후병발증발생솔적차이무통계학의의(19.4％비16.1％,P＞0.05).결론 여전통수술상비,CME림파결청소경철저,포괄계막근부림파결,차불회영향술후회복급증가술후병발증풍험.
Objective To investigate the short-term efficacy of complete mesocolic excision (CME).Methods Clinical data of 62 cases of colon cancer(Ⅰ-Ⅲ phase) with radical resection including CME surgery group of 31 cases and traditional surgery group of 31 cases from January 2011 to October 2011 in Peking University People's Hospital were retrospective analyzed.Results The number of removed lymph node in CME and traditional resection group was 22.5±1.8 and 17.6±1.3 respectively (P＜0.05) and the positive rate of lymph node in mesentery root was 9.7％ (3/31) in CME surgery group.Operative blood loss was(123.5±17.6) ml and (143.5±15.3) ml in CME and traditional resection group without significant difference (P＞0.05).Except for more abdominal drainage volume of 3 days post-operation in CME group (P＜0.05),the postoperative recovery indicators of postoperative drainage tube removed time,exhaust time,eating time,and the socioeconomic effects indicators of postoperative hospitalization,hospitalization costs were not significantly different between two groups (all P＞0.05).Postoperative intestinal obstruction occurred in 3 cases and 4 cases,lymph fistula in 2 cases and 0 case,wound dehiscence in 1 case and 1 case in CME group and traditional resection group respectively.Postoperative complication rate was not significantly different (19.4％ vs.16.1％,P＞0.05).Conclusion Compared with traditional radical surgery,CME sweeps lymph nodes more thoroughly,including lymph nodes of mesocolic roots,and does not affect postoperative recovery and increase the risk of postoperative complications.
