腹腔镜直肠癌根治保留左结肠血管的技巧及意义

Significance and surgical techniques of laparoscopic LCA-preservingrectal surgery

腹腔镜直肠癌根治有高位结扎和低位结扎处理肠系膜下动脉两种方式,高位结扎肠系膜下动脉可能会影响吻合口的血运,从而导致吻合口漏的发生。低位结扎保留了左结肠动脉(LCA),能够改善吻合口的血供。按照全直肠系膜切除原则,腹腔镜下保留LCA进行直肠癌术还需对肠系膜下动脉根部淋巴结进行D3清扫。本文结合国内外文献,对腹腔镜保留LCA直肠癌根治的意义及相关手术技巧进行综述。

Curative resection of rectal cancer could be achieved by both ＂high ligation＂ and ＂low ligation＂ of the inferior mesenteric artery （IMA）. However, ＂high ligation ＂ could influence the blood supply of anastomotic stoma, which might increase leakage risk. ＂ Low ligation＂ preserves the left colic artery （LCA） , which could increase the blood supply of anastomotic stoma. According to the principle of total mesenterectomy, LCA-preservingrectal surgery should also include 253 lymph nodes resection. Combined domestic and foreign literature, this article aimed to investigate the significance and surgical techniques of laparoscopic LCA-preservingrectal surgery.