| Objective:To investigate difference of the surgical operative principle of complete mesocolicexcision (CME) and traditional surgeries in patients of colon cancer,and research thedifference on tumor radical index,opearation related index, postoperative effects and theprognostic.objectives to the operative principle and clinical application values of completemesocolic excision (CME) and traditional operation for patients with colon cancer.Methods:A retrospective analysis clinical data and follow-up results of colon cancer in patientsby the same group of surgeons at Jilin University General surgery Hospital from november31,2010to January31,2013, which were devided into two groups of CME group andcontrol group in surgical approach.78cases who received CME in Jilin University Generalsurgery Hospital,were enrolled in the CME group.57cases who received traditionaloperation, were chosen as controls. All clinical cases were the clinical research methods ofanalyzed retrospectively and contrast in this study.Lymph nodes yield,surgicalindex,postoperative dffects and the short-termprognosis were compared.Results:Mean number of lymph nodes of CME group was（21.3±3.1）, mean number of lymphnodes of control group was（19.7±2.8）, mean number of lymph nodes was increasedobviously in CME group, with statistical significance in the mean number of lymph nodescompared with the control group (t=-3.178,p=0.002). mean number of lymph nodes of StageI were not statistically different between two groups of CME group and control group, meannumber of lymph nodes of Stage II were not statistically different between two groups ofCME group and control group (Stage I t=-1.563, p=0.138, Stage II t=-1.871, p=0.067). meannumber of lymph nodes of Stage III between the two groups harvested (22.6±3.1) and(20.9±2.2), when CME was in patients with colon cancer, mean number of lymph nodes ofStage III ticks up as well, which is statistically significant in this study (t=-2.404,p=0.019).The number of positive lymph nodes of Stage Ⅲbetween CME groupand control group harvested (2.9±1.8) and (2.0±1.5). the positive lymph nodes of CMEgroup was higher than control group,but it was statistically significant (P=0.041). The meanblood loss of CME group was（114.2±15.0）ml, mean blood loss of traditional operationgroup was (120.5±16.5)ml, mean blood loss of CME group was less than traditionaloperation group,That’s a statistically significant difference （t=2.273,p=0.025). Meanoperative time, mean time of exhaust, mean time of defecation, and length of hospital staywere not statistically different between two groups of CME group and control group(p>0.05).The overall postoperative morbidity rate was14.1percent for CME and19.3percent for those who received traditional operation, That’s no statistically significantdifference.（x2=0.652，P=0.419).In the study, CME had one-year overall recurrence rate of0percent, compared with3.8percent for control group,but this was not statistically significantin the one-year overall recurrence rate between two groups（X2=1.985，P=0.159).Theone-year overall mortality rate was0percent for CME and3.8percent for those whoreceived traditional operation, control group had a higher one-year overall mortality rate,while CME, one-year overall mortality rate was decreased, That’s no statistically significantdifference（X2=1.985，P=0.159). The two-year overall recurrence rate was4.0percent forCME and18.2percent for those who received traditional operation, control group had ahigher one-year overall recurrence rate, while CME, one-year overall mortality rate wasdecreased, That’s no statistically significant difference（X2=1.824，P=0.177).The two-yearoverall mortality rate of CME group was4.0percent, The one-year survival rate of controlgroup was18.2percent, but this was not statistically significant in two-year overall mortalityrate between CME group and control group（（X2=1.824，P=0.177）.Conclusion:The surgical method of complete mesocolic excision for colon cancer in elderlypatients is better than traditional surgeries, The surgical method of complete mesocolicexcision for colon cancer in elderly patients reduces blood loss. number of lymph nodes ofcomplete mesocolic excision for colon cancer in elderly patients was obviously higher thantraditional surgeries. number of lymph nodes of stage III obviously more than traditionalsurgeries, The complete mesocolic excision not increases operation risk and overallpostoperative morbidity rate.Both one-year overall recurrence rate and two-year overall recurrence rate of complete mesocolic excision (CME) and traditional operation for patientswith colon cancer were equal prognosis significance. The one-year overall survival rate ofsurgical method for patients with colon cancer were the same prognosis value.The two-yearoverall survival rate with colon cancer of surgical method has the same prognosissignificance.The short-termprognosis was similar in complete mesocolic excision andtraditional operation patients. |
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