低位结扎并根部淋巴结清扫在腹腔镜直肠癌根治术中的应用价值

Application value of low ligation and root lymph node dissection in laparoscopic radical resection of rectal cancer

目的探讨低位结扎并根部淋巴结清扫在腹腔镜直肠癌根治术中的应用价值。方法选择行腹腔镜直肠癌根治术并根部淋巴结清扫的78例患者为研究对象,采用随机数字表法将其分为观察组(低位结扎+根部淋巴结清扫)与对照组(高位结扎+根部淋巴结清扫),各39例。比较两组患者的治疗效果。结果两组总淋巴结清扫数目、IMA根部淋巴结清扫数目、手术时间、术中出血量均无显著差异(P>0.05);观察组术后排气时间与术后住院时间均短于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05);术后14 d,两组血清胃动素与胃泌素水平均低于术前1 d,但观察组高于对照组(P<0.05)。结论腹腔镜直肠癌根治术中,低位结扎并根部淋巴结清扫不会增加创伤,且能减少术后并发症,利于术后胃肠动力恢复,促进患者康复。

Objective To investigate the application value of low ligation and root lymph node dissection in laparoscopic radical resection of rectal cancer.Methods A total of 78 patients who underwent laparoscopic radical resection of rectal cancer and root lymph node dissection were selected as the study objects and divided into observation group(low ligation+root lymph node dissection)and control group(high ligation+root lymph node dissection)according to the random number table method,with 39 cases in each group.The therapeutic effects of the two groups were compared.Results There were no significant differences in the number of total lymph node dissection and root lymph node dissection in IMA,operation time and intraoperative bleeding volume between the two groups(P>0.05).The postoperative exhaust time and hospitalization time in the observation group were shorter than those in the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).At 14 days after operation,the levels of serum motilin and gastrin in both groups were lower than those in the first day before operation,but those in the observation group were higher than the control group(P<0.05).Conclusion In laparoscopic radical resection of rectal cancer,low ligation and root lymph node dissection will not increase trauma and can reduce postoperative complications,which is conducive to the recovery of gastrointestinal motility and promote the recovery of patients.