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中华普通外科学文献(电子版) ›› 2018, Vol. 12 ›› Issue (03) : 170 -173. doi: 10.3877/cma.j.issn.1674-0793.2018.03.004

所属专题: 文献

论著

结肠脾曲肿瘤左半结肠切除术与扩大右半结肠切除术临床对比研究
石磊1, 雍伟2,(), 晏殊2   
  1. 1. 610000 成都市第七人民医院医教部
    2. 610000 成都市第七人民医院普外科
  • 收稿日期:2017-12-29 出版日期:2018-06-01
  • 通信作者: 雍伟

Comparative study of left and enlarged right hemicolectomy for patients with colonic splenic flexure

Lei Shi1, Wei Yong2,(), Shu Yan2   

  1. 1. Department of Medical Education, the Seventh People’s Hospital of Chengdu, Chengdu 610000, China
    2. Department of General Surgery, the Seventh People’s Hospital of Chengdu, Chengdu 610000, China
  • Received:2017-12-29 Published:2018-06-01
  • Corresponding author: Wei Yong
  • About author:
    Corresponding author: Yong Wei, Email:
引用本文:

石磊, 雍伟, 晏殊. 结肠脾曲肿瘤左半结肠切除术与扩大右半结肠切除术临床对比研究[J/OL]. 中华普通外科学文献(电子版), 2018, 12(03): 170-173.

Lei Shi, Wei Yong, Shu Yan. Comparative study of left and enlarged right hemicolectomy for patients with colonic splenic flexure[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2018, 12(03): 170-173.

目的

探讨左半结肠切除术(LC)对比扩大右半结肠切除术(RC)对结肠脾曲肿瘤患者疗效状况。

方法

回顾性分析2010年10月至2012年10月成都市第七人民医院进行手术治疗的结肠脾曲肿瘤患者90例,其中行LC手术42例(LC组),行RC手术48例(RC组)。观察两组患者手术情况(R0切除率、手术死亡率、手术时间、术中出血量、淋巴结清扫数情况),以及术后排气时间、住院时间、阳性淋巴结和二次手术状况,随访分析手术后并发症、平均生存期及1、3、5年生存率,ELISA法检测手术前后患者血清白细胞介素6、10(IL-6、IL-10)及γ-干扰素(IFN-γ)质量浓度的改变。

结果

两组患者R0切除率、手术死亡率、手术时间、术中出血量、淋巴结清扫数、术后排气时间、住院时间和二次手术对比差异无统计学意义。LC组患者并发症率为16.67%,RC组为18.75%,差异无统计学意义。术后两组患者血清IL-10、IL-6质量浓度较术前降低,IFN-γ较术前升高,差异均有统计学意义(P<0.05);RC组患者平均生存期和1、3年生存率高于LC组,差异有统计学意义(Log-rank=12.027、13.491,P=0.038、0.014)。

结论

RC手术长期疗效略优于LC手术,结肠脾曲肿瘤患者手术前确定淋巴结回流路径和肿瘤血供评估将更有利于患者选取合适手术方式。

Objective

To compare the curative effect of left hemicolectomy (LC) and enlargement of right hemicolectomy (RC) for splenic flexure tumors of colon.

Methods

From October 2010 to October 2012, a retrospective analysis of ninety patients with colon splenic tumors undergoing surgery in the Seventh People’s Hospital of Chengdu was performed. Among them, 42 patients underwent LC surgery and 48 patients underwent RC surgery. The correlation between operation and postoperative indicators, postoperative complications and long-term survival status, the changes of serum IL-6, IL-10 and IFN-γ in patients before and after operation were detected by ELISA method.

Results

There were no significant differences in R0 resection rate, mortality, operative time, bleeding, the number of lymph nodes, postoperative exhaust time, hospitalization stay and reoperation between the two groups. The rate of complication was 16.67% in group LC and 18.75% in group RC, the difference was not statistically significant. The serum levels of IL-10 and IL-6 in the two groups were significantly lower than those before the operation and the levels of IFN-γ were significantly higher (P<0.05). The average survival period and 1-, 3- year survival rate of RC group were higher than those of LC group, the differences were statistically significant (Log-rank=12.027, 13.491; P=0.038, 0.014).

Conclusions

The long-term effect of RC surgery is slightly better than that of LC operation for patients with colonic splenic flexure. Preoperative evaluation of lymph node circumfluence and tumor blood supply can be more favorable for patients to choose suitable operation mode.

表1 两组结肠脾曲肿瘤患者临床资料比较
表2 两组结肠脾曲肿瘤患者术中及术后相关指标状况对比
表3 手术前后结肠脾曲肿瘤患者血清IL-6、IL-10及IFN-γ质量浓度变化(ng/L, ±s
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