摘要
目的探讨乙状结肠癌伴肠梗阻患者实施完整结肠系膜切除术的临床疗效。方法选择2012年1月至2016年12月在芜湖市第一人民医院接受乙状结肠癌切除手术的65例乙状结肠癌伴肠梗阻患者,回顾分析患者的临床、病理等资料。根据外科术式,65例患者分为观察组(33例)和对照组(32例),观察组采用完整结肠系膜切除术,对照组采用传统乙状结肠癌切除术,比较两组患者手术安全性指标、切除标本的测量指标及生存率。结果两组患者手术操作时间差异有统计学意义(P<0.05),术中出血量、术后输白蛋白量、术后肛门排气时间、术后进食时间、术后并发症差异均无统计学意义(P>0.05),观察组切除肠管长度长于对照组,清扫淋巴结总数多于对照组,差异均有统计学意义(P<0.05),而两组患者的肿瘤浸润肠管环周宽度、肿瘤浸润肠管长度及清扫肠旁组阳性淋巴结数差异无统计学意义(P>0.05)。术后随访,观察组患者累计生存率和累计无瘤生存率均优于对照组,差异有统计学意义(P<0.05)。结论与传统乙状结肠癌切除术相比,乙状结肠癌伴肠梗阻患者实施完整结肠系膜切除术的手术时间长,但手术安全性良好,能有效地降低复发率、提高生存率,值得临床推广应用。
ObjectiveTo investigate the clinical value of complete mesorectal excision in patients with sigmoid colon cancer and intestinal obstruction.MethodsFrom January2012to December2016,65patients with sigmoid colon cancer who underwent sigmoid colon resection in First People's Hospital of Wuhu City were enrolled in this study.The patients were divided into observation group(33cases)and control group(32cases).The former received complete mesorectal excision and the latter conventional sigmoid colon resection.Then the surgical safety indexes,resection specimens and survival rates were compared between the two groups.Results The two groups had statistically significant differences in operation time(P<0.05),while intraoperative blood loss,amount of postoperative albumin,postoperative anal exhaust time,postoperative eating time,postoperative complications showed no significant difference between the two groups(P>0.05).In the resection of intestine length and the number of lymph nodes dissected,the length of excision intestine in observation group was significantly longer than that in control group.The total number of lymphaden nodes in observation group was significantly larger than that in control(P<0.05).However,there was no significant difference between the two groups in the intestine circumferential width of tumor infiltration,the length of intestine infiltration and the number of positive lymph node dissection(P>0.05).Postoperative follow-up,the cumulative survival rate and cumulative tumor-free survival rate in observation group were higher than those in control with statistically significant difference(P<0.05)Conclusions Compared with the conventional resection of sigmoid colon,the complete colon mesenteric surgery in the treatment of sigmoid colon cancer with intestinal obstruction for patients may last for a long time,but it is still worth the clinical application due to its safety,reduced recurrence rate and elevated survival rate.
作者
李志贵
邱钧
吴鹏飞
LI Zhigui;QIU Jun;WU Pengfei(Department of General Surgery, the First People's Hospital of Wuhu, Wuhu 241000, China)
出处
《安徽医学》
2017年第12期1537-1540,共4页
Anhui Medical Journal
关键词
完整结肠系膜切除
乙状结肠肿瘤
肠梗阻
临床疗效
Complete colonic mesorectal excision
Sigmoid colon cancer
Intestinal obstruction
Clinical efficacy
