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目的探讨“中间入路”完整结肠系膜切除术(complete mesocolic excision,CME)治疗右半结肠癌的可行性。方法 2011年1月至2013年12月对41例右半结肠癌的患者行“中间入路”完整结肠系膜切除术(CME)。结果 41例患者均顺利完成完整结肠系膜切除术(CME),术后病理分期:17例T4aN0M0、13例T3N0M0、11例T4aN1M0。手术用时110~220min(平均160min);术中出血量50~200mL(平均100mL);淋巴结切除数14~38个(平均23个);术后3~6d(平均4.5d)肛门排气;术后住院天数7~13d(平均9.5d);无死亡病例,无并发症发生,所有患者均痊愈出院。随访2~35个月,无复发、转移,仍生存。结论 CME治疗右半结肠癌是安全、可行的,能达到系膜和淋巴组织切除的最大化,并未增加手术风险,术后短期治疗效果良好,不影响患者康复。
Objective To investigate the feasibility of complete mesocolic excision (CME) in the treatment of right colon cancer. Methods From January 2011 to December 2013, 41 patients with right colon cancer underwent an “intermediate approach” with complete mesorectal resection (CME). Results Forty-one patients successfully completed complete mesorectomies (CME). Postoperative pathological staging: 17 cases of T4aN0M0, 13 cases of T3N0M0, and 11 cases of T4aN1M0. The operation time was 110~220min (mean 160min); the intraoperative blood loss was 50~200mL (mean 100mL); the lymph node resection number was 14~38 (average 23); postoperative 3~6d (mean 4.5d) anal exhaust; The number of days after hospitalization was 7-13 days (average 9.5 days); no deaths occurred, no complications occurred, and all patients were cured and discharged. Follow-up of 2 to 35 months, no recurrence, metastasis, and survival. Conclusion CME is safe and feasible for the treatment of right colon cancer. It can maximize the removal of mesangial and lymphoid tissues, does not increase the surgical risk, and has a good short-term therapeutic effect. It does not affect the recovery of patients.