目的 探讨完整结肠系膜切除治疗老年肥胖患者结肠癌的临床效果.方法 选取2011年1月至2013年1月苏州市立医院本部收治的老年肥胖伴结肠癌患者66例,按照入院先后顺序分为观察组和对照组,各33例.观察组行完整结肠系膜切除术,对照组行结肠癌根治术.观察2组临床疗效、并发症发生情况、复发情况、术后出血量、清理淋巴结个数以及术后1年和2年生存率.结果 2组患者在治疗后临床疗效均较好,观察组和对照组总有效率比较[78.8％(26/33)比72.7％(24/33)],差异无统计学意义(P＞0.05).观察组术后并发症发生率和复发率均明显低于对照组、1年和2年生存率均明显高于对照组[6.1％ (2/33)比48.5％ (16/33),6.1％ (2/33)比24.2％(8/33),90.9％(30/33)比63.6％(21/33),81.8％(27/33)比51.5％(17/33)],差异均有统计学意义(均P＜0.05).观察组清除淋巴结数明显多于对照组[(25.1±3.3)个比(11.5±2.1)个],术后出血量明显少于对照组[(127±4) ml比(177±3)ml],差异均有统计学意义(均P ＜0.05).结论 完整结肠系膜切除治疗老年肥胖患者结肠癌临床疗效明显,并发症少,安全可行.%Objective To evaluate the effect of complete mesocolic excision in treating colons cancer in elderly obese patients.Methods Totally 66 elderly obese patients with colon cancer from January 2011 to January 2013 were randomly divided into observation group (33 cases) receiving complete mesocolon excision and control group (33 cases) receiving colon resection.The clinical efficacy,complications,recurrence,postoperative blood loss,number of resected lymph nodes,and survival rates of 1 and 2 years were recorded and compared between groups.Results The effective rate was not significantly different between observation group and control group [78.8％ (26/33) vs 72.7％ (24/33)] (P ＞0.05);the rates of complication and recurrence were significantly lower,the survival rates of 1 and 2 years were significantly higher in observation group than those in control group [6.1％ (2/33)vs48.5％ (16/33),6.1％ (2/33)vs24.2％ (8/33),90.9％ (30/33)vs63.6％ (21/33),81.8％ (27/33) vs 51.5％ (17/33)] (P ＜ 0.05);the number of resected lymph node was significantly more,the operative blood loss was significantly less in observation group than those in control group [(25.1 ± 3.3) vs (11.5 ±2.1),(127 ±4) ml vs (177 ±3) ml] (P＜0.05).Conclusion In elderly obese patients,complete resection mesocolon has great clinical efficacy in treating colon cancer,with fewer complications compared with colon resection.
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