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复杂结直肠癌中央血管结扎完整结肠系膜切除术的疗效与可行性

Efficacy and Feasibility of Complete Mesocolic Excision with Central Vascular Ligation in Complicated Colorectal Cancer.

作者信息

Torky Radwan A, Abdel-Tawab Mohamed, Rafaat Abadeer, Hefni Ahmed Mubarak, Abdelmotaleb Ahmed

机构信息

Department of Surgery, main hospital, Assiut Faculty of Medicine, Assiut University, Assiut, 71515 Egypt.

Department of Diagnostic and Interventional Radiology, main hospital, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

Indian J Surg Oncol. 2023 Jun;14(2):312-317. doi: 10.1007/s13193-022-01673-w. Epub 2022 Oct 28.

Abstract

Complete mesocolic excision (CME) with central vascular ligation (CVL) involves sharp dissection through the embryological planes. However, it may be associated with high mortalities and morbidities especially in colorectal emergencies. This study aimed to investigate the outcomes of CME with CVL in complicated colorectal cancers (CRCs). This was a retrospective study of emergency CRC resection in a tertiary center between March 2016 and November 2018. A total of 46 patients, with a mean age of 51 years, underwent an emergency colectomy for cancer (males, 26 [56.5%]; females, 20 [43.5%]). CME with CVL was performed for all patients. The mean operative time and blood loss were 188 min and 397 mL, respectively. Only five (10.8%) patients presented with burst abdomen, whereas only three (6.5%) presented with anastomotic leakage. The mean length of vascular tie was 8.7 cm, and the mean number of harvested lymph nodes (LNs) was 21.2. Emergency CME with CVL is a safe and feasible technique when performed by a colorectal surgeon and will result in obtaining a superior specimen with a large number of LNs.

摘要

完整结肠系膜切除术(CME)联合中央血管结扎术(CVL)需要通过胚胎学层面进行锐性分离。然而,尤其是在结直肠急症中,它可能与高死亡率和高发病率相关。本研究旨在调查CME联合CVL治疗复杂性结直肠癌(CRC)的效果。这是一项对2016年3月至2018年11月期间在一家三级中心进行的急诊CRC切除术的回顾性研究。共有46例患者,平均年龄51岁,接受了癌症急诊结肠切除术(男性26例[56.5%];女性20例[43.5%])。所有患者均进行了CME联合CVL。平均手术时间和失血量分别为188分钟和397毫升。只有5例(10.8%)患者出现腹部裂开,而只有3例(6.5%)出现吻合口漏。血管结扎的平均长度为8.7厘米,平均获取的淋巴结(LN)数量为21.2个。由结直肠外科医生进行急诊CME联合CVL是一种安全可行的技术,并且将获得带有大量LN的优质标本。

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