Han Zhen, Liu Yangan, Tan Ming, Hua Zhaolai, Dai Chun
Medical College, Yangzhou University, Yangzhou, Jiangsu, China.
Department of General Surgery, Yangzhong People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhong, Jiangsu, China.
Technol Health Care. 2025;33(1):449-462. doi: 10.3233/THC-241149.
Surgery remains the most effective treatment for colon cancer. However, there are still controversies regarding the tumor treatment effect, prognosis, and perioperative impact of complete mesocolic excision (CME) surgery in colon carcinoma resection.
This study aims to compare laparoscopic complete mesocolic excision (LCME) and traditional open D2 radical surgery in colon carcinoma resection through a retrospective analysis using 1:1 propensity score matching (PSM).
98 cases undergoing LCME or open D2 colon carcinoma resection at our hospital from January 2014 to November 2021 were retrospectively collected. After excluding cases and 1:1 matching using PSM based on baseline clinical data, 86 patients were assigned in research queue. 43 patients were in each group. Two groups were compared for general clinical baseline indicators. Surgical results and postoperative adverse events of patients were also compared. Disease-free survival (DFS) rate and overall survival (OS) rate was analyzed.
After 1:1 PSM matching, there was no statistically significant differences in baseline data between the LCME group and D2 group (P> 0.05). LCME was characterized by longer total duration of surgery (P< 0.001), less intraoperative bleeding volume (P< 0.001), more postoperative drainage fluid volume (P< 0.001), greater number of lymph nodes retrieved (P= 0.014). No statistically differences was observed regarding intraoperative blood transfusion, hospital stay, Clavien-Dindo complicating disease classification (all P> 0.05), 1 and 3-year DFS rate (P= 0.84) and OS rate (P⩾ 0.1).
LCME had a longer duration of surgery but less intraoperative bleeding volume and more postoperative drainage fluid volume and retrieved lymph nodes compared to D2 radical surgery. LCME surgery is comparable to D2 surgery in terms of postoperative prognosis, but LCME surgery shows a positive trend in the overall survival curve.
手术仍然是结肠癌最有效的治疗方法。然而，关于完全结肠系膜切除术（CME）在结肠癌切除术中的肿瘤治疗效果、预后及围手术期影响仍存在争议。
本研究旨在通过1:1倾向评分匹配（PSM）的回顾性分析，比较腹腔镜完全结肠系膜切除术（LCME）与传统开放性D2根治术在结肠癌切除术中的效果。
回顾性收集2014年1月至2021年11月在我院接受LCME或开放性D2结肠癌切除术的98例患者。在排除病例并根据基线临床数据使用PSM进行1:1匹配后，86例患者被纳入研究队列。每组43例。比较两组的一般临床基线指标、手术结果及患者术后不良事件。分析无病生存率（DFS）和总生存率（OS）。
经过1:1 PSM匹配后，LCME组与D2组的基线数据无统计学差异（P>0.05）。LCME的特点是手术总时长较长（P<0.001）、术中出血量较少（P<0.001）、术后引流量较多（P<0.001）、获取的淋巴结数量较多（P=0.014）。术中输血、住院时间、Clavien-Dindo并发症分类方面均无统计学差异（均P>0.05），1年和3年DFS率（P=0.84）及OS率（P⩾0.1）也无统计学差异。
与D2根治术相比，LCME手术时间较长，但术中出血量较少，术后引流量及获取的淋巴结较多。LCME手术在术后预后方面与D2手术相当，但在总生存曲线上呈积极趋势。
