摘要
目的探讨完整结肠系膜切除(CME)在腹腔镜右半结肠癌根治术中的应用效果及对应激指标的影响。方法回顾性分析2011年1月至2015年11月腹腔镜下行CME的150例右半结肠癌患者资料,另选取150例2005年1月至2008年12月腹腔镜下按照传统方式行右半结肠癌根治术的右半结肠癌患者资料,分为CME组和传统组,采用SPSS 19.9软件对数据进行统计分析,围手术期指标、应激反应指标以均数±标准差表示,采用独立t检验;术后并发症比较采用χ2检验,P<0.05为差异有统计学意义。结果 CME组的手术时间显著高于传统组,P<0.05;两组患者的术中出血量、术后排气时间、开始下床活动时间、住院时间、术后并发症差异无统计学意义,P>0.05;CME组的淋巴结清扫(23.1±4.0)枚、阳性淋巴结(5.6±2.9)枚,明显高于传统组(22.1±3.8)枚、(4.7±1.8)枚,差异有统计学意义(t=2.22,t=3.23,P<0.05);术前两组患者应激反应指标比较无显著差异,P>0.05;术中两组患者应激反应指标较术前均显著升高,但是CME组患者皮质醇、肾上腺素、去甲肾上腺素、血管紧张素Ⅱ水平显著低于传统组,差异有统计学意义,P<0.05。结论 CME对机体的创伤、应激反应较小,并减少肿瘤细胞挤压后的扩散,患者的远期生存率尚待长期随访。
Objective To explore the effect of complete mesocolic resection （ CME） in laparoscopic right radical colon cancer resection . Methods From 2011 Jan to 2015 Nov, 150 cases of right colon cancer treated with CME and from 2005 Jan-to 2008 Dec, 150 cases treated with traditional surgery were retrospectively analyzed and compared as the CME group and traditional group with 150 cases in each group , the clinical data of perioperative , stress reaction and so on were compared , P〈0.05 for the difference was statistically significant . Results The operation time of the CME group was significantly higher than that of the traditional group, P〈0.05.There was no statistically significant difference between the intraoperative hemorrhagic amount , postoperative exhaust time , the start of the bed activity , the time of hospitalization and postoperative complications in the two groups of patients , P〉0.05;The lymph node dissection of the CME group （23.1 ±4.0 ） and positive lymph nodes （ 5.6 ±2.9 ） were significantly higher than that of the traditional group （22.1 ±3.8） and （4.7 ±1.8）.The difference was statistically significant , P〈0.05;There was no significant difference in the stress response indexes in the two groups before operation , P〉0.05;In the two groups, thestress reaction index were significantly elevated after operation , the cortisol and epinephrine , norepinephrine , angiotensin Ⅱ level in the CME group was significantly lower than in the traditional group, the difference was statistically significant , P〈0.05. Conclusion The CME has a small response to the body ＆#39; s trauma and stress , and reduces the spread of tumor cells , and the long-term survival rate of the patient remains to be followed for a long time .
出处
《中华普外科手术学杂志（电子版）》
2017年第6期504-506,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
