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目的探讨完整结肠系膜切除(complete mesocolic excision,CME)在老年结肠癌病人手术治疗中的应用价值。方法回顾性分析2011-01-31至2011-12-31,就诊于吉林大学第二医院基本外科同一手术治疗组老年结肠癌病人的临床资料。36例行CME手术治疗(为CME组),28例行传统根治术治疗(为对照组),比较两组手术效果。结果 CME组与对照组淋巴结清扫数量分别为(22.4±3.3)枚、(19.5±3.1)枚,两组比较差异有统计学意义(P=0.001);Ⅲ期淋巴结清扫数量CME组为(23.8±3.8)枚,对照组为(20.7±2.7)枚,差异有统计学意义(P=0.010),Ⅲ期淋巴结阳性数CME组为(3.4±2.3)枚,对照组为(2.1±1.4)枚,差异有统计学意义(P=0.047)。CME组术中出血量少于对照组,差异有统计学意义(P=0.020)。手术并发症发生率比较差异无统计学意义(P=0.628)。结论老年结肠癌病人应用CME优于传统手术方式,不增加手术风险及术后并发症发生率。
Objective To investigate the value of complete mesocolic excision (CME) in the surgical treatment of elderly patients with colon cancer. Methods The clinical data of elderly patients with colorectal cancer who underwent the same surgical treatment in the Department of Basic Surgery, the Second Hospital of Jilin University from January 2011 to December 31, 2011 were retrospectively analyzed. 36 cases of CME surgery (for the CME group), 28 cases of conventional radical mastectomy (control group), the two groups were compared. Results The number of lymph node dissection in CME group and control group were (22.4 ± 3.3) and (19.5 ± 3.1), respectively, with statistical significance (P = 0.001). The number of stage Ⅲ lymph node dissection in CME group was (23.8 ± (3.4 ± 2.3) in the CME group and (2.1 ± 1.4) in the control group, respectively (P = 0.010) The difference was statistically significant (P = 0.047). The blood loss in CME group was less than that in control group, the difference was statistically significant (P = 0.020). The incidence of complications was no significant difference (P = 0.628). Conclusion The application of CME in elderly patients with colon cancer is superior to the traditional surgical methods, without increasing the risk of surgery and the incidence of postoperative complications.