中国实用外科杂志

中国实用外科杂志

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完整结肠系膜切除在老年人结肠癌手术治疗中应用价值

贾国梁，李国栋，房学东，辛    贺，吴元玉   

  1. 吉林大学第二医院基本外科，吉林长春130041
  • 发布日期:2012-10-19

  • Published:2012-10-19

摘要：

目的    探讨完整结肠系膜切除（complete mesocolic excision，CME）在老年结肠癌病人手术治疗中的应用价值。 方法    回顾性分析2011-01-31 至2011-12-31，就诊于吉林大学第二医院基本外科同一手术治疗组老年结肠癌病人的临床资料。36例行CME手术治疗（为CME组），28例行传统根治术治疗（为对照组），比较两组手术效果。结果    CME组与对照组淋巴结清扫数量分别为（22.4±3.3）枚、（19.5±3.1）枚，两组比较差异有统计学意义（P=0.001）；Ⅲ期淋巴结清扫数量CME组为（23.8±3.8）枚，对照组为（20.7±2.7）枚，差异有统计学意义（P=0.010），Ⅲ期淋巴结阳性数CME组为（3.4±2.3）枚，对照组为（2.1±1.4）枚，差异有统计学意义（P=0.047）。CME组术中出血量少于对照组，差异有统计学意义（P=0.020）。手术并发症发生率比较差异无统计学意义（P=0.628）。 结论   老年结肠癌病人应用CME优于传统手术方式，不增加手术风险及术后并发症发生率。

关键词: 完整结肠系膜切除, 结肠癌, 老年病人

Abstract:

Clinical research of complete mesocolic excision for elderly patients with colon cancer        JIA Guo-liang, LI Guo-dong, FANG Xue-dong, et al. Department of General Surgery, the Second Hospital, Jilin University, Changchun 130041, China
Corresponding author: LI Guo-dong, E-mail:liguodong@jlu.edu.cn
Abstract    Objective    To investigate the clinical application values of complete mesocolic excision (CME) for elderly patients with colon cancer. Methods    The clinical data of 64 cases of elderly patients with colon cancer admitted between January 31, 2011 and December 31, 2011 in the Department of General Surgery, Second Hospital of Jilin University were analyzed retrospectively. All the cases were divided into two groups. Thirty-six cases were performed CME (CME group). Twenty-eight cases were performed traditional surgical resection (control group). The clinical effects of two groups were compared. Results    Mean number of lymph nodes of CME group and control group harvested (22.4±3.3) and (19.5±3.1) respectively. There was significant difference in the mean number of lymph nodes between the two groups (P=0.001).  Mean number of lymph nodes of Stage Ⅲ between the two groups harvested (23.8±3.8) and (20.7±2.7). The results showed that mean number of lymph nodes of CME group was significantly obviously higher than control group (P=0.010). The number of positive lymph nodes of Stage Ⅲ between the two groups harvested (3.4±2.3) and (2.1±1.4). The results showed that mean number of positive lymph nodes of CME group was significantly obviously higher than control group (P=0.047).  Mean blood loss of CME group was significantly obviously less than control group（P=0.020). But there was no significant difference in the overall postoperative complication incidence between two groups（P=0.628). Conclusion    CME for colon cancer in elderly patients is better than traditional surgery without more operation risk or postoperative complication incidence.

Key words: complete mesocolic excision；colon cancer, elderly patients