開腹全結腸系膜切除治療右半結腸癌的療效分析

但操

[摘要] 目的 探究開腹全結腸系膜切除治療右半結腸癌的臨床效果。方法 隨機選取2012年10月—2014年11月在該院接受結腸癌治療的60例患者為研究對象，依據治療方式不同分為實驗組和對照組，實驗組接受開腹全結腸系膜切除術治療，對照組接受傳統結腸癌根治術治療，分析比較兩組患者的各項臨床指標。結果 實驗組患者的術中出血量明顯低于對照組患者，清掃淋巴個數則顯著高于對照組，兩組患者上述數據間的差異具有統計學意義（P﹤0.05）；而手術時間的差異無統計學意義（P﹥0.05）；術后實驗組和非實驗組患者的平均住院時間、術后通氣時間、術后大便時間、腸管切除長度等指標之間的差異無統計學意義（P﹥0.05）。結論 全結腸系膜切除手術可以完整的切除系膜組織及病灶，降低術中出血量、清掃更多的淋巴結，是一種治療結腸癌的有效術式。

[關鍵詞] 全結腸系膜切除術；右半結腸癌；結腸癌傳統根治術；淋巴結清掃

[中圖分類號] R73 [文獻標識碼] A [文章編號] 1674-0742（2015）05（a）-0068-02

Analysis of Therapeutic Effect of Right Colon Cancer Resection and Open Total Mesocolon

DAN Cao

Chibi Hubei People's Hospital General Surgery，Chibi，437300 China

[Abstract] Objective To explore the abdominal complete mesocolic excision treatment clinical effect of right colon cancer. Methods Select 60 cases accepted the treatment of colon cancer in our hospital patients as the research object from 2011 October to 2014 November. The experimental group and the control group received the abdominal complete mesocolic excision treatment and traditional radical resection of colon cancer， respectively. Analyzing the difference of two groups of patients indicators. Results The amount of bleeding in operation of the patients in experimental group was significantly lower than that of the control group patients， lymph number was significantly higher than that of the control group， the differences between the two groups were significant between this data and have statistical significance（P﹤0.05）. Conclusion Complete mesocolic excision operation can complete resection of the mesangial tissue and lesions， reduce the amount of bleeding during operation， which was an effective surgical treatment for colon cancer.

[Key words] Complete mesocolic excision； The right colon cancer；The traditional radical resection of colon cancer； Lymph node dissection

結腸癌是一種常見的消化道惡性腫瘤，發病率呈逐年上升趨勢，當前仍以手術方式治療結腸癌[1]。當前國內外專家已重視到規范外科手術的重要性，有關專家提出CME（完整結腸系膜切除術）術式的關鍵點是正確找到壁層筋膜和臟層筋膜間的自然間隙，并將其游離至血管的根部，然后結扎血管，以確保結腸系膜的完整性，并完整切除被臟層筋膜包繞的纖維脂肪組織、淋巴結、淋巴管及系膜血管等結構，相比于傳統的手術治療方式，CME術式更加科學、規范，已經逐步成為結腸癌治療的標準術式[2-3]。……