Retrospective Analysis Of Surgical Treatment Of 270 Cases Of Transverse Colon Cancer

Background and purpose Surgical treatment of colon cancer based on the concept of total mesocolon resection has been widely accepted,especially in the right and left hemicolectomy,which are relatively fixed.However,for transverse colon cancer,there is still considerable controversy at home and abroad.The operation is flexible and has not yet been unified.In this study,by observing the short-term and long-term outcomes of various indicators,we compared and evaluated the surgical treatment of transverse colon cancer based on CME.To explore an effective and individualized surgical method for transverse colon cancer.Method From October 2013 to October 2015,270 patients underwent open radical resection of transverse colon cancer in the Department of gastrointestinal surgery of Shandong Provincial Hospital were selected.Among them,108 cases underwent conventional resection and 52 cases underwent extended resection.The short-term effects of gender,age,BMI,length of operation,intraoperative bleeding,lymph node dissection,length of hospitalization,time of first movement after operation,time of first exhaust of anus after operation,complications after operation and long-term effects of local recurrence and 3-year survival rate after operation were retrospectively analyzed.Result 1.There was no significant difference in gender,age,body mass index,time of first activity,time of first feeding,length of hospitalization and short-term complications among the three groups.2.Observation of Short-term Therapeutic Effect2.1 Right lateral Transverse colon resection:the length of operation,the amount of bleeding during operation,the number of lymph node dissection,and time of first exhaust of anus after operation had statistical significance.2.2 Intermediate transverse colon resection:The amount of bleeding during operation and the length of operation had statistical significance.2.3 Left lateral transverse colon resection:length of operation,amount of bleeding during operation,number of lymph node dissection had statistical significance.3.Long-term efficacy3.1 Following up for 3 years,there was no recurrence in stage ? patients,2 patients in stage ? and 11 patients in stage ?.The average recurrence rate was 8.13%.There was statistical significance.There was no significant difference in recurrence rate 1between conventional resection and extended resection in 3 years.3.2 3 years after operation one patient died in stage ?,Six patients died in stage II.Twelve patients died in stage ?.The average 3-year survival rate was 88.12%.Conclusion The pathological type of transverse colon cancer is ulcerative moderately and poorly differentiated adenocarcinoma,accounting for about 60%of the total.In the surgical treatment of transverse colon cancer,the short-term recovery after extended resection is worse than that after conventional resection.There was no significant difference in 3-year prognosis between conventional resection and extended resection based on CME resection strategy.Individualized surgical management of transverse colon cancer should be performed according to the location of the tumor and potential lymphatic metastasis pattern.