钱　飞　徐　欣　冯　轲　付　强

云南省玉溪市人民医院普外一科（昆明医科大学第六附属医院），云南昆明653100

改良右半结肠切除术并顺行性淋巴结清扫治疗右半结肠癌的效果分析

钱飞徐欣▲冯轲付强

云南省玉溪市人民医院普外一科（昆明医科大学第六附属医院），云南昆明653100

目的研究改良右半结肠切除术并顺行性淋巴结清扫治疗右半结肠癌的效果。方法选取我院2010年1月～2011年1月期间收治的右半结肠癌患者100例，根据随机数字表法分为改良组和传统组。传统组采取传统手术方式治疗，改良组采取改良右半结肠切除术并顺行性淋巴结清扫治疗。比较两组患者手术操作时间、淋巴结清扫量、术中总出血量、淋巴结转移复发率和腹膜种植复发率、并发症发生率、5年生存率。结果改良组淋巴结转移复发率和腹膜种植复发率、并发症发生率明显低于传统组，5年生存率明显高于传统组（P＜0.05）。改良组患者淋巴结清扫量稍多于传统组，但差异无统计学意义（P＞0.05）。改良组患者手术操作时间、术中总出血量均少于传统组（P＜0.05）。结论改良右半结肠切除术并顺行性淋巴结清扫治疗右半结肠癌的效果确切，符合无瘤操作原则，可降低复发率，提高远期生存率，对患者预后有益，值得借鉴。

改良右半结肠切除术；顺行性淋巴结清扫；右半结肠癌；出血量；腹膜种植复发率

［Abstract］Objective To study the effects of modified right hemicolectomy combined with anterograde clearance of lymph nodes in the treatment of right hemicolon carcinoma.Methods A total of 100 patients with right hemicolectomy who were admitted to our hospital from January 2010 to January 2011 were selected.They were assigned to two groups，modified group and traditional group，according to the random number table.The traditional group was given traditional surgical procedures for the treatment；the modified group was given modified right hemicolectomy combined with anterograde clearance of lymph nodes for the treatment.Surgical time，amount of cleaned lymph nodes，total amount of bleeding during surgery，relapse rates of lymphatic metastasis and peritoneal implantation，incidence rate of complications and five-year survival rate were compared between the two groups of patients.Results Relapse rates of lymphatic metastasis and peritoneal implantation，and incidence rate of complications were significantly lower than those in the traditional group，and the five-year survival rate was significantly higher than that in the traditional group（P＜0.05）.The amount of cleaned lymph nodes in the modified group was slightly more than that in the traditional group，but there was no significant difference（P＞0.05）.Surgical time，and total amount of bleeding during surgery in the modified group were both lower or shorter than those in the traditional group（P＜0.05）.Conclusion Modified right hemicolectomy combined with anterograde clearance of lymph nodes in the treatment of right hemicolon carcinoma has exact effects，which is in accordance with the non-tumor operating principle.This procedure is able to reduce the relapse rate and improve longterm survival rate，which is beneficial to patients'prognosis and worthy of practice.

［Key words］Modified right hemicolectomy；Anterograde clearance of lymph nodes；Right hemicolon carcinoma；Amount of bleeding；Relapse rate of peritoneal implantation

结肠癌为结肠部位常见恶性肿瘤，早期多以消化不良、腹胀为主要表现，随着病情进展可出现黏液脓性血便、腹痛等症状，对患者生存质量造成严重影响［1，2］。……