专题研究(Monographic Study)

完整肠系膜切除术治疗III期结肠癌的效果及安全性分析

Published at: 2016年第25卷第4期

郑桁 1 , 张伟 1 , 王康 1
1 四川省医学科学院/四川省人民医院 胃肠外科,四川 成都 610072
通讯作者 桁 郑 Email: zhengxin743@sina.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.04.005
基金:

摘要

目的:探讨完整肠系膜切除术(CEM)治疗III期结肠癌的临床效果。方法:回顾性分析129例III期结肠癌患者的临床资料,其中采用CEM治疗62例(CEM组)、采取传统结肠癌根治术67例(传统组),比较两组围手术期指标及术后复发、生存情况。结果:与传统组比较,CEM组手术时间(159.4 min vs. 168.9 min)、术后排气时间(4.3 d vs. 4.5 d)、禁食时间(5.4 d vs. 5.7 d)、留置管引流时间(9.4 d vs. 10.0 d)、住院时间(15.3 d vs. 16.0 d)、术后并发症发生率(4.84% vs. 10.45%)差异均无统计学意义(均P>0.05),但手术出血量明显减少(126.4 mL vs. 155.1 mL,P<0.05)、淋巴结清扫数目明显增加(32.6枚 vs. 28.3枚,P<0.05);CEM组与传统组术后1、2年的复发率(3.23% vs. 5.97%;14.52% vs. 20.90%)和1、2年的存活率(98.39% vs. 95.52%;90.32% vs. 83.58%)差异均无统计学意义(均P>0.05)。结论:CEM治疗III期结肠癌与传统结肠癌根治术效果相当,具有手术出血量少,淋巴结清扫更彻底的优势。


Analysis of efficacy and safety of complete mesorectal excision in treatment of stage III colon cancer

Abstract

Objective: To investigate the clinical efficacy of complete mesorectal excision (CEM) in treatment of stage III colon cancer. Methods: The clinical data of 129 patients with stage III colon cancer were retrospectively analyzed. Of the patients, 62 cases underwent CEM procedure (CEM group), and 67 cases were subjected to traditional colon cancer radical resection (traditional group). The perioperative variables and postoperative recurrence and survival between the two groups of patients were compared. Results: Compared with traditional group, in CEM group the operative time (159.4 min vs. 168.9 min), time to flatus (4.3 d vs. 4.5 d), duration of fasting (5.4 d vs. 5.7 d), retention time of drainage tube (9.4 d vs. 10.0 d), length of hospital stay (15.3 d vs. 16.0 d) and overall incidence of postoperative complications (4.84% vs. 10.45%) showed no statistical difference (all P>0.05), but the intraoperative blood loss was decreased (126.4 mL vs. 155.1 mL, P<0.05) and number of dissected lymph nodes was increased (32.6 vs. 28.3, P<0.05). There was no statistical difference between CEM group and traditional group in either 1- and 2-year recurrence rate (3.23% vs. 5.97%; 14.52% vs. 20.90%) or 1- and 2-year survival rate (98.39% vs. 95.52%; 90.32% vs. 83.58%), (all P>0.05). Conclusion: CEM has similar efficacy as traditional radical surgery in treatment of stage III colon cancer, with advantages of less bleeding and more extensive lymph node dissection.


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引用

引用本文: 桁 郑, 伟 张, 康 王. 完整肠系膜切除术治疗III期结肠癌的效果及安全性分析[J]. 中国普通外科杂志, 2016, 25(4): 487-491.
Cite this article as: ZHENG Heng, ZHANG Wei, WANG Kang . Analysis of efficacy and safety of complete mesorectal excision in treatment of stage III colon cancer [J]. Chin J Gen Surg, 2016, 25(4): 487-491.