摘要为了将结肠癌切除术标准化,学者们提出了全结肠系膜切除(CME)的概念,即在直视下连续锐性分离,将脏层筋膜层从壁层分离,获得被脏层筋膜层完全包被的整个结肠系膜,保证安全地暴露并结扎供血动脉起始部.CME的核心目的是通过标准化的手术步骤,最大化地清扫肿瘤负载区域的淋巴结,从而进一步提高结肠癌的手术疗效.CME的肿瘤学优势为保证获得由完整结肠系膜包被的肿瘤标本,防止因结肠系膜内血管及淋巴引流暴露而增加肿瘤播散的概率;从根部结扎血管可以保证获得最多的淋巴结检出数量.初步研究显示,CME并血管高位结扎可以明显提高Ⅲ期患者的疗效,对于其他分期患者的疗效有待进一步研究.目前尚未得出腹腔镜是否适合行CME手术的结论.

abstractsThe concept of complete mesocolic excision (CME) is proposed by scholars to standardize the surgery for colon cancer. Surgical separation is performed by sharp dissection of the visceral fascia layer from the parietal fascia resulting in complete mobilization of the entire mesocolon covered by an intact visceral fascial layer on both sides ensuriug safe exposure and ligation of the supplying arteries at their origin.The preessential aim of CME is to improve the surgical quality by ensuring maximal harvest of the regional lymph nodes through the standardized surgical technique.The advantages of CME includes two important oncological vantages:probability of the potentially tumor spread caused by the the torn lymphovascular vessels is reduced by achieving an adequate tumor package; central vascular ligation ensures maximal lymph node harvest.CME benefits the survival of patients with stage Ⅲ tumor.More studies will be needed to assess the effects of CME on the other stages.Whether the laparoscopic surgery can achieve CME is still unknown now.