全结肠系膜切除术与传统结肠癌根治术在右半结肠癌手术中的对比研究

目的 探讨右半结肠癌开腹CME术的短期疗效和安全性.方法 回顾分析2010年12月至2012年12月由同一组手术医师收治的76例行CME术的右半结肠癌患者临床资料,并与2009年1月至2010年11月由同一组手术医师收治的65例行传统结肠癌根治术的右半结肠癌患者比较短期疗效和安全性.结果 CME组手术时间较传统手术组稍长,2组比较差异有统计学意义（P=0.004）,术中出血量比较差异无统计学意义（P=0.421）;CME组清扫淋巴结总数、切除肠管长度较传统手术组多,2组比较差异有统计学意义（P〈0.001,P=0.004）,2组的阳性淋巴结比较差异无统计学意义（P=0.070）;术后排气时间、住院时间、术后并发症比较差异均无统计学意义（分别为P=0.082,P=0.183,P=0.562）.规律随访后所有患者均存活,CME组局部复发率为5.26%明显低于传统开腹组13.84%（P=0.036）;CME组的远期转移率为6.58%,与传统开腹组6.15%比较差异无统计学意义（P=0.918）.结论 对于右结肠癌根治术而言,CME术是一种短期疗效好而且安全的手术方式.

Comparison of Complete Mesocolic Excision and Traditional Radical Surgery for Right-Side Colon Cancer

Objective To evaluate the short-term efficacy and safety of complete mesocolic ex cision（CME） in right-side colon cancer. Methods Clinical data of 76 right-side colon cancer pa tients who underwent CME from December 2010 to December 2012（CME group） and 65 right side colon cancer patients who underwent traditional radical surgery from January 2009 to No vember 2010 （traditional surgery group） were retrospectively analyzed. Short-term efficacy and safety were compared between the two groups. Results Compared with traditional surgery group,operation time, number of lymph nodes retrieved and length of bowel excised significantly increased in CME group（P〈0.01）. There were no obvious differences in intraoperative blood loss,positive lymph nodes, postoperative anal exhaust time, hospital stay and complications be tween the two groups（P〈0.05）. All patients survived during the regular follow-up period. The local recurrence rate in CME group was significantly lower than that in traditional surgery group （5.26% vs 13.84%,P〈0.01）,but there was no significant difference in the distant metastasis rate between the two groups（P〉0.05）. Conclusion CME has good short-term efficacy and safe ty for right-side colon cancer.