腹腔镜结肠癌全系膜切除术临床疗效观察及预后探讨

目的探讨结腹腔镜肠癌全结肠系膜切除术(complete mesocolic excision,CME)与开腹手术对结肠癌(colon cancer,CC)患者的临床疗效和预后的影响。方法选取2016年8月至2019年8月我院普外科收治的84例CC患者,按照手术方式的不同分为腹腔镜组和开腹组。比较两组患者术中手术时间、出血量、淋巴结清扫数量等指标,术后通气时间、住院时间和并发症发生率等指标,长期随访局部复发率、远处转移率、无瘤生存率以及生存质量FACT-G评分。结果腹腔镜组患者术中出血量、术后通气时间、住院时间以及并发症发生率显著低于开腹组,手术时间长于开腹组,各阶段生存质量评分明显优于对照组(P<0.05);两组间淋巴结清扫数量、远处转移率、局部复发率及无瘤生存率等差异无统计学意义(P>0.05)。结论结肠癌腹腔镜CME较开放手术具有明显优势,患者预后良好,近期疗效满意,值得推广。

Clinical observation and prognosis analysis of laparoscopic complete mesocolic excision for colon cancer

Objective To investigate the effects of laparoscopic complete mesocolic excision(CME)and laparotomy on the clinical efficacy and prognosis of patients with colon cancer(CC).Methods Eighty-four patients with CC who were admitted to the department of general surgery of our hospital from August 2016 to August 2019 were divided into laparoscopic group and laparotomy group according to different surgical methods.The indicators such as operation time,bleeding volume,and number of lymph node cleanings during the operation were compared between the two groups.The indicators such as postoperative ventilation time,hospital stay and complication incidence were also compared between the two groups.The local recurrence rate,distant metastasis rate,tumor-free survival rate and quality of life FACT-G score were recorded through long-term follow-up.Results The intraoperative bleeding volume,postoperative ventilation time,hospital stay and complication rate were lower or shorter,the operation time was longer and the quality of life scores at each stage were significantly better in the laparoscopic group than those in the laparotomy group(P<0.05).There was no significant difference in the number of lymph node dissection,distant metastasis rate,local recurrence rate and tumor-free survival rate between the two groups(P>0.05).Conclusion Laparoscopic CME for colon cancer has obvious advantages over open surgery.The patients have a good prognosis and a satisfactory short-term efficacy.It is worthy of promotion.