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全结肠系膜切除术与传统根治术治疗结肠癌的临床效果比较

Comparison of the effect of CME and traditional colon resection in the treatment of colon cancer

摘要:

目的:比较全结肠系膜切除术( CME)与传统结肠癌根治术治疗结肠癌的安全性及治疗效果。方法选择CME治疗的结肠癌患者共58例编入A组,同期常规手术方法治疗的结肠癌患者共58例编入B组。比较两组手术效果、患者术后恢复情况以及术后并发症的发生情况等。结果 A组平均术中出血量(95.5±15.8)mL,明显少于B组的(138.4±23.5)(t=32.718,P<0.05),两组平均清扫Ⅰ期与Ⅱ期淋巴结个数差异无统计学意义(t=0.085、0.078,均P>0.05),A组Ⅲ期淋巴结清扫个数明显多于B组(t=3.548,P<0.05)。 A组术后3天平均引流量(223.1±19.4)mL,多于B组的(134.1±16.8)mL(t=13.975,P<0.05)。其余术后恢复情况如拔除引流管时间、排气时间、进食时间以及住院总时间等在A、B两组间差异均无统计学意义( t=0.018、0.000、0.000、0.012,均P>0.05)。 A组发生并发症3例,并发症发生率为5.17%;B组发生并发症6例,并发症发生率为10.34%,A组并发症发生率明显低于B组(χ2=3.785,P<0.05)。结论 CME术式具有向精细解剖发展的特点,有利于结肠癌外科手术的质量控制,安全性较好,效果确切,值得临床推广。

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abstracts:

Objective To compare the safety and effect of complete mesocolic excision ( CME) and tradi-tional colon resection in the treatment of colon cancer .Methods 58 colon cancer patients received CME were selected as A group,and 58 colon cancer patients received traditional colon resection during the same time were selected as B group.The effect of surgery,postoperative recovery and postoperative complications were compared between the two groups.Results The average blood loss in A group was (95.5 ±15.8)mL,which was less than (138.4 ±23.5)mL in B group (t=32.718,P<0.05).There was no significant difference in number of lymph nodes dissection at stageⅠand Ⅱbetween the two groups (t=0.085,0.078,all P>0.05).The number of lymph nodes dissection at stage&nbsp;Ⅲin A group was more than that in B group(t=3.548,P<0.05).3 days after operation,the average drainage in A group was (223.1 ±19.4)mL,which was more than (134.1 ±16.8)mL in B group (t=13.975,P<0.05).There were no significant differences in drainage tubes unplugged time ,flatus time,eating time and the total hospitalization time between the two groups(t=0.018,0.000,0.000,0.012,all P>0.05).There were 3 cases with complication in A group,and the incidence rate was 5.17%,while 6 cases in B group,the incidence rate was 10.34%,the incidence rate of complication in A group was significantly lower than that in B group (χ2 =3.785,P<0.05).Conclusion It has the feature of fine dissecting to operate CME and it was conducive to quality control of colon cancer surgery .It has better security and definite effect .It is worthy of clinical application .

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