保留左结肠动脉的腹腔镜直肠癌根治术在老年直肠癌患者中的应用研究

Saving-Left Colonic Artery Laparoscopic Radical Surgery for Senior Rectal Cancer:Application Study

目的:探讨老年直肠癌患者行保留左结肠动脉(LCA)的腹腔镜直肠癌根治术的安全性及可行性。方法:回顾2019年8月至2021年3月于我科接受腹腔镜直肠癌根治术的80例患者资料,以术中是否保留LCA分组,即保留组(39例)和未保留组(41例)。比较2组患者围手术期指标及术后并发症发生情况。结果:2组患者手术时间、术中出血量、肠系膜下动脉(IMA)根部淋巴结清扫数、淋巴结清扫总数、术后吻合口出血和尿潴留发生率比较差异均无统计学意义(P>0.05),但保留组患者术后首次排气时间及住院时间均短于未保留组(P<0.05),吻合口漏发生率低于未保留组(P<0.05)。结论:老年患者腹腔镜直肠癌根治术中保留LCA安全可行,而且可降低术后吻合口漏发生率,促进肠功能恢复。

Objective To explore the safety and feasibility of saving-left colonic artery(LCA)laparoscopic radical surgery in the treatment of senior rectal cancer.Methods Reviewed the data of 80cases met above conditions and treated in author's department(2019-08-2021-03),according to with or without saving-LCA divided them into saving group(39cases)and non-saving group(41cases);then,compared both groups'perioperative norms and the status on postoperative complication incidence.Results In operating time,intraoperative bleeding volume,the numbers of lymph-node removed in inferior mesenteric artery(IMA)radix,the total numbers of lymphnode removed,as well as the incidence of bleeding from stoma after surgery,and of uroschesis there was no statistical difference between the two groups(P>0.05);but,in the time for postoperative first flatus,and for hospitalization,as well as in the incidence of stoma leakage saving group was respectively shorter,as well as lower than non-saving group(P<0.05).Conclusion In the laparoscopic radical surgery for rectal cancer,saving-LCA is safe and feasible,can reduce the incidence of postoperative stoma leakage,and promote intestinal function recovered.