腹腔镜直肠乙状结肠手术中近端肠管的保护

Protection of the proximal colon segment during laparoscopic proctosigmoidectomy

结合首都医科大学附属朝阳医院普通外科行腹腔镜直肠乙状结肠手术中出现的11例近端肠管血运障碍的情况，对术中近端肠管的保护进行探讨。分析认为，腹腔镜直肠乙状结肠手术中近端肠管血运改变与结肠系膜血管的解剖学因素及手术操作有关。对于中低位直肠癌手术，术中保留左结肠动脉并于低位处理肠系膜下动脉，有利于降低血管解剖变异所引起的近端肠管出现血运障碍的风险。

To evaluate the protection of proximal colon segment by analyzing blood supply disorder of proximal colon segment during laparoscopic proctosigmoidectomy （11 cases） in the Chaoyang Hospital of Capital Medical University. It is concluded that the disorder of blood supply of proximal colon segment during laparoscopic proctosigmoid surgery has two reasons. One is the anatomic factor of mesenteric vessels; the other is the inappropriate operative procedure. It is recommended that left colonic artery should be retained, and inferior mesenteric artery should be handled at a low level, thus, the risk of proximal intestine blood supply disorder caused by vascular anatomy variation can be reduced.