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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (02) : 148 -151. doi: 10.3877/cma.j.issn.1674-3946.2020.02.013

所属专题: 文献

论著

腹腔镜下右半结肠癌CME的临床疗效及随访
陈亮1, 肖栋1, 马建仓2,()   
  1. 1. 723100 陕西,汉中3201医院肿瘤外科
    2. 710004 西安交通大学第二附属医院普外科
  • 收稿日期:2019-08-27 出版日期:2020-04-26
  • 通信作者: 马建仓

Clinical outcome of laparoscopic CME for right colon cancer during follow-up period

Liang Chen1, Dong Xiao1, Jiancang Ma2,()   

  1. 1. Department of Oncology surgery, Hanzhong 3201 Hospital, Shaanxi 723100, China
    2. Department of General surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Shaanxi 710004, China
  • Received:2019-08-27 Published:2020-04-26
  • Corresponding author: Jiancang Ma
  • About author:
    Corresponding author: Ma Jiancang , Email:
  • Supported by:
    Key planning project of Department of Science and Technology of Shaanxi Province(NO.2017JM5069)
引用本文:

陈亮, 肖栋, 马建仓. 腹腔镜下右半结肠癌CME的临床疗效及随访[J/OL]. 中华普外科手术学杂志(电子版), 2020, 14(02): 148-151.

Liang Chen, Dong Xiao, Jiancang Ma. Clinical outcome of laparoscopic CME for right colon cancer during follow-up period[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(02): 148-151.

目的

探究腹腔镜全结肠系膜切除术(LCME)治疗右半结肠癌的临床疗效及中期生存情况。

方法

回顾性分析2014年6月至2016年6月94例右半结肠癌CME手术的临床资料,根据选取术式不同分为LCME组(腹腔镜下全结肠系膜切除术,50例)和OCME组(开腹全结肠系膜切除术,44例)。采用统计软件SPSS 21.0进行数据分析,围术期指标和免疫学指标采用(±s)表示,行独立t检验;并发症等行χ2检验;采用KaplanMeier法进行预后生存分析,以P<0.05差异有统计学意义。

结果

(1)LCME组在切口长度、术中出血量、淋巴结清扫数目、胃肠道恢复蠕动时间、止痛泵点滴时间和住院时长等方面优于OCME组(P<0.05);(2)LCME组T淋巴细胞亚群及NK细胞水平优于OCME组(P<0.05);(3)生存分析显示,术后3年两组患者无病生存率及总生存率差异无统计学意义(P>0. 05)。两组患者在生存质量方面并无明显差异。

结论

LCME术中出血量少,创伤小,疼痛轻,术后恢复快,安全可行,值得推广。

Objective

To explore the clinical outcome of laparoscopic CME for right colon cancer during follow-up period.

Methods

From June 2014 to June 2016, clinical data of 94 patients with right colon cancers, who received laparoscopic CME, were analyzed retrospectively, including 50 cases in LCME group (laparoscopic complete mesocolic excision) and 44 cases in OCME group (open complete mesocolic excision). Statistical analysis were performed by using SPSS 21.0 software. Measurement data such as Perioperative indicators and Immunological index were expressed as (±s) and were examined by using independent t test. Count data were examined by using χ2 test. Kaplan-meier method was used to analyze survival. A P value <0.05 was considered as statistically significant difference.

Results

(1) Compare with OCME group, there were several advantages in LCME group, including less incision length and intraoperative blood loss, more harvested lymph nodes, faster gastrointestinal tract recovery, shorted analgesic pump drip time and hospital stay (P<0.05). (2) The levels of T lymphocyte subsets and NK cells in LCME group were better than those in OCME group respectively (P<0.05). (3) There were no significant difference between the two groups in terms of 3 years disease-free survival and all survival (P>0.05). There were no significant difference in quality of life between two groups.

Conclusion

LCME could ahieve less bleeding, less trauma, less pain and faster recovery, with safety and feasibility, .It is worth of clinical promotion.

表1 94例右半结肠癌患者不同术式两组患者一般资料对比[(±s),例]
表2 94例右半结肠癌患者不同术式两组患者围手术指标比较(±s)
表3 94例右半结肠癌患者不同术式两组患者术后并发症情况对比(例)
表4 94例右半结肠癌患者不同术式两组患者T淋巴细胞亚群及NK细胞水平比较[(±s),%]
图1 94例右半结肠癌患者不同术式两组患者无病生存率和总生存率比较
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