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The Clinical Effect Observation of Right Hemicolectomy with D3 Lymph Node Dissection for Progressive Right-sided Colon Cancer

Author: FangXianCun
Tutor: MaChong
School: Jilin University
Course: Surgery
Keywords: The Right Hemicolectomy with D3 Lymph Node Dissection lymph node No-Tumor Procedure
CLC: R735.35
Type: Master's thesis
Year: 2011
Downloads: 47
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Abstract


With the change of living environment and diet and the complication of social psychic factors,the morbidity of colon cancer has been increasing at present all over the world.While the fatality of it has been No.4 among the fatalities of all malignant tumors.Some records says:the 5-year survival rate of colon cancer is about 60%.For that reason,we must pay more attention to the discovery,diagnose and therapy of the cancer of colon,the earlier ,the better.Operation is undoubtedly the most effective method to treat the patients of colon cancer.Therefore,as a surgeon,we must do more homework on the specifications of operation,operations cannot get the expective therapeutic efficacy with careless attitude.Because of the raising tendency of morbility of the right hemicolon cancer,one kind of the colon cancer,said some records recent years,and its complicated anatomic structure,it is controversial on the extent of the lymph node in a radical operation on right hemicolon cancer. Recent records reports that extensive sweeping of lymph node,to D3 lymph nodes, can obviously improve the prognosis of people who has the right hemicolon cancer.D3 radical correction of right hemicolon cancer has been accepted by surgeons as normal operation in Japan.But this kind of operation hasn’t been a normal one in our country,because it has more challenge,higher risk of bleeding as the complicated anatomic structure of right hemicolon vessels.This paper analyzes whether D3 radical correction of right hemicolon cancer should be used in clinical as a more regular surgery by studying the clinical contradistinction between 2 groups patients who were performed with D2 and D3 radical correction of right hemicolon cancer respectively.Objective:Analysis the effect of living and survival quality of patients with Progressive Right-sided Colon Cancer after Right Hemicolectomy with D3 Lymph Node Dissection。Method: From January 2004 to January 2005, 62 patients (39 male, 23 female) with Progressive Right-sided Colon Cancer were performed with Right Hemicolectomy with D3 Lymph Node Dissection in the Department of Gatric Colorectal and Anus Disease, the Third Affiliated Hospital of Jilin University. The staging of Dukes: 13 cases were stage A, 19 cases were stage B, 30 cases were stage C. Other 59 (37male, 22 female) patients are used as control group by operating Right Hemicolectomy with D2 Lymph Node Dissection. The staging of Dukes: 11 cases were stage A, 20 cases were stage B, 28 cases were stage C. Stage D did not operate. All patients give chemotherapy for 6 cycles. All statistic patients are for the first time surgery. Comparing the operating time, blood loss, postoperative exhaust time,in-hospital time,the number of examined lymph node,local recurrence rate,and 2-year, 5-year survival rate .Result:(1) There was not statistically significant in sex, age, pathohistological type and differentiation degree of colon carcinoma Dukes staging in two groups,P>0.05.(2) There was no statistically significant in operating time, blood loss, postoperative exhaust time and in-hospital time in two groups,P>0.05.(3) There was significant differences in the local recurrence and 2-year, 5-year survival rate of the two groups,P<0.05,group A is better than group B. As the staging of Dukes,there was no significant differences in the local recurrence and 2-year, 5-year survival rate of Dukes A groups,P>0.05.But There was statistically significant in the local recurrence and 2-year, 5-year survival rate of Dukes BandC groups,group A is better than group B.Conclusion: The Right Hemicolectomy with D3 Lymph Node Dissection should be a standard operate procedure to Progressive Right-sided Colon Cancer.Comparing with Right Hemicolectomy with D2 Lymph Node Dissection:①Improving the 2-year、5-year survival rate among patients with Progressive Right-sided Colon Cancer,and decreasing the rate of local recurrence, improving the living and survival quality of patients obviously②The Right Hemicolectomy with D3 Lymph Node Dissection can not give patients extra body injury and economic burden.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms > Colon tumor
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