完整结肠系膜切除术治疗大肠癌对患者围手术期的影响分析

摘要

Objective To study the influence of complete mesocolon resection on perioperative period in patients with colorectal cancer.Methods 84 patients with colorectal treated at our hospital from May 2013 to May 2014 were selected and divided into an observation group and a control group using random number table method,42 cases for each group.The control group were treated by traditional radical surgery and the observation group by complete mesocolon resection.All the patients were followed up 3 years.The levels of operative indicators,the incidence of postoperative complications,local recurrence rate,3-year survival rate,and quality of life were compared between these two groups.Results The anal exhaustion time,lymph node cleaning number,and length of hospital stay in the observation group were (4.3±1.1) d,(26.6±3.8),and (10.3±2.0) d,which were significantly lower than those in the control group [(6.4±1.3) d,(17.8±3.2),and (16.4±2.3) d],with statistical differences (all P ＜ 0.05).The incidence of postoperative complications was 9.52％ (4/42) in the observation group and was 26.19％ (11/42) in the control group,with a statistical difference (P ＜ 0.05).The postoperative local recurrence rate was 14.29％ (6/42) in the observation group and was 33.33％ (14/42) in the control group,,with a statistical difference (P ＜ 0.05).The 3-year survival rate was 83.33％ (35/42) in the observation group and was 61.90％ (26/42) in the control group,with a statistical difference (P ＜ 0.05).After the treatment,the scores of quality of life were significantly higher in the observation group than in the control group,with statistical differences (all P ＜ 0.05).Conclusion Complete mesocolon resection for patients with colorectal cancer is significantly effective and safe and can effectively decrease the incidence of postoperative complications and improve prognosis,so it worth being clinically generalized.%目的 研究完整结肠系膜切除术治疗大肠癌对患者围手术期的影响.方法 选取2012年5月至2014年5月本院收治的结肠癌患者84例,根据随机数字表法分成观察组和对照组,每组42例;对照组患者予以传统根治术治疗,观察组患者则予以完整结肠系膜切除术治疗;对所有患者进行为期3年的随访,比较两组各项手术指标水平、术后并发症发生率、局部复发率、3年存活率以及生活质量.结果 观察组患者肛门排气恢复时间、淋巴结清扫数、住院时间分别为(4.3±1.1)d、(26.6±3.8)枚、(10.3±2.0)d,均显著优于对照组的(6.4±1.3)d、(17.8±3.2)枚、(16.4±2.3)d,差异均有统计学意义(均P＜0.05);观察组患者术后并发症发生率为9.52％(4/42),显著低于对照组的26.19％(11/42),差异有统计学意义(P＜0.05);观察组术后局部复发率为14.29％(6/42),显著低于对照组的33.33％(14/42),而3年存活率为83.33％(35/42),显著高于对照组的61.90％(26/42),差异均有统计学意义(均P＜0.05);观察组患者治疗后各项生活质量评分均显著高于对照组,差异均有统计学意义(均P＜ 0.05).结论 完整结肠系膜切除术治疗结肠癌患者的效果显著,可有效降低术后并发症发生率,改善预后,安全性较好,值得临床推广应用.