摘要
目的：探讨完整结肠系膜切除（CME）在结肠癌手术治疗中的应用。方法：回顾性分析2009年12月-2012年6月行CME和中央血管高位结扎（CVL）的34例结肠癌患者临床资料。结果：患者术后UICC病理分期：I期4例，II期14例，III期16例。中位淋巴结清扫数18枚，III期患者中18．8％（3／16）的系膜根部淋巴结转移阳性。全组无围术期死亡，无术中副损伤。手术时间2．5～3．5（中位数2．75）h，术中出血量80～200（中位数110）mL，术后排气时间3-5（中位数4）d，排便时间4-6（中位数5）d，术后住院时间11～20（中位数14）d。术后并发症包括切口感染3例，肺部感染1例，乳糜漏1例，无吻合口瘘发生，近期无肠梗阻发生。34例患者获6个月至2年的随访，未发现局部复发；1例术后16个月发现肝转移，3个月后死亡。结论：结肠癌患者行CME联合CVL安全、可行，短期效果良好，CME联合CVL有可能成为一种标准化的结肠癌手术术式。
Objective： To investigate the application of complete mesocolic excision （CME） in colon cancer surgery. Methods： The clinical data of 34 patients with colon cancer undergoing CME with central vascular ligation （CVL） between December 2009 and June 2012 were retrospectively analyzed. Results： The postoperative UICC pathological stages of the patients were stage I in 4 cases, stage II in 14 cases and stage III in 16 cases, respectively. The median number of lymph nodes dissected was 18 lymph nodes, and 18.8% （3/16） of the stage III patients had positive metastatic lymph nodes in the root of the mesocolon. There was no perioperative death or associated injury in the entire group. The operative time was 2.5-3.5 （median 2.75） h, intraoperative blood loss was 80-200 （median 110） mL, time to first passing of flatus and first defecation after surgery was 3-5 （median 4） d and 4-6 （median 5） d, respectively, and length of postoperative hospital stay was 11-20 （median 14） d. The postoperative complications included 3 cases of wound infection,and one case each of lung infection and chyle leakage. There was no anastomotic leak or bowel obstruction dunng the short postoperative period. The 34 patients were followed up for 6 months to 2 years during which no local recurrence occurred, but one case developed liver metastases 16 months after surgery and died 3 months later. Conclusion： CVL combined with CME for colon cancer is safe and feasible, and has favorable short-term efficacy. It can possibly become a standardized surgical technique for colon cancer.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2012年第10期1208-1211,共4页
China Journal of General Surgery
