Wang Tie, Ye Ying-jiang, Han Ya-mei, Gao Zhi-dong, Guo Peng, Yang Xiao-dong, Jiang Ke-wei, Yin Mu-jun, Wang Shan
Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Mar;16(3):264-7.
To investigate the short-term efficacy of complete mesocolic excision (CME).
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.
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).
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.
探讨完整结肠系膜切除术(CME)的短期疗效。
回顾性分析北京大学人民医院2011年1月至2011年10月期间行根治性切除术的62例结肠癌(I - III期)患者的临床资料,其中CME手术组31例,传统手术组31例。
CME组和传统切除组的清扫淋巴结数目分别为22.5±1.8枚和17.6±1.3枚(P<0.05),CME手术组肠系膜根部淋巴结阳性率为9.7%(3/31)。CME组和传统切除组的术中出血量分别为(123.5±17.6)ml和(143.5±15.3)ml,差异无统计学意义(P>0.05)。除CME组术后3天腹腔引流量较多外(P<0.05),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学效应指标差异均无统计学意义(均P>0.05)。CME组和传统切除组术后肠梗阻分别发生3例和4例,淋巴瘘分别发生2例和0例,伤口裂开分别发生1例和1例。术后并发症发生率差异无统计学意义(19.4% vs. 16.1%,P>0.05)。
与传统根治性手术相比,CME清扫淋巴结更彻底,包括结肠系膜根部淋巴结,且不影响术后恢复,不增加术后并发症风险。