摘要
目的探讨52例非梗阻性结肠脾曲癌患者的脾曲解剖特点、手术要点及疗效。方法回顾性分析河南省肿瘤医院普通外科2004年3月至2011年3月间收治的52例非梗阻性结肠脾曲癌患者的临床资料。结果根据术中所见，52例患者结肠脾曲为系膜型者37例，游离型者5例，粘连型者10例。所有患者均行根治性手术，18例患者行原位结肠吻合，其中系膜型者12例（32．4％），游离型者4例（4／5），粘连型者2例（20．0％），粘连型比例低于系膜型，但差异并未达到统计学意义（P=0．062）：另32例患者行回肠后结肠吻合。3种脾曲解剖类型患者手术时间、术中出血量、淋巴结清扫总数、阳性淋巴结数量、术后并发症的差异均无统计学意义（均P〉O．05）。52例患者术后均获随访，系膜型者、游离型和粘连型患者术后5年生存率分别为62．5％、59．2％和58．7％，差异无统计学意义（P〉O．05）。结论解剖学类型并不影响脾曲癌根治术中结肠吻合的方式，但经回肠后方吻合可有效保障结肠脾曲癌的切除范围．有助于提高手术根治性．
Objective To investigate the anatomic characteristics of splenic flexure, surgical techniques, and oncologic outcomes in 52 patients with non-obstructive splenic flexure colon cancer. Methods Clinical data of 52 patients with non-obstructive splenic flexure colon cancer from March 2004 to March 2011 in the Department of General Surgery at the Henan Province Tumor Hospital were analyzed retrospectively. Results There were 37 patients of regular type, 5 of mobile type, and 10 of adhesive type. All the patients received radical operation. Eighteen patients received pre-small intestine anastomosis, including 12 cases with regular type, 4 with mobile type, and 2 with adhesive type. The difference in pre-small intestine anastomoisis among the three types was not statistically significant （P=0.062）. In addition, 32 cases received retro-ileum anastomosis. There were no significant differences in operative time, intraoperative blood loss, number of lymph node dissection and positive lymph node, and postoperation complication rate among the three types. Follow up was available in all the cases. Five-year survival rates of cases with regular type, mobile type and adhesive type were 62.5%, 59.2% and 58.7% respectively （P〉0.05）. Conclusions Radical resection can provide satisfactory survival for splenic flexure colon cancer patients. The anatomy of splenic flexure does not affect the type of anastomosis. Retro-ileum anastomosis is a simple and effective method for reconstruction after radical
出处
《中华胃肠外科杂志》
CAS
北大核心
2011年第10期790-792,共3页
Chinese Journal of Gastrointestinal Surgery
关键词
结肠肿瘤
脾曲
解剖学特征
外科手术
治疗效果
Colonic neoplasms, splenic flexure
Anatomic characteristics
Surgical procedures
Treatment outcomes
