腹腔镜下直肠癌前切除术中保留左结肠动脉对患者肛肠功能的影响分析

Analysis of the Effect of Preserving the Left Colon Artery on Anorectal Function During Laparoscopic Anterior Resection of Rectal Cancer

目的:研究腹腔镜下直肠癌前切除术中保留左结肠动脉与否对患者肛肠功能等方面的影响,从而为直肠癌患者手术治疗工作提供参考。方法:选择本院2018年8月~2019年8月收治手术治疗的直肠癌患者,总计66例。腹腔镜手术下结合术中保留左结肠动脉与否进行随机分组,即术中不保留左结肠动脉的对照组(n=33)、术中保留左结肠动脉的观察组(n=33)。对比对照组与观察组腹腔镜下直肠癌前切除术患者的手术时间、术中出血量、术后排气时间以及术后肛门功能评分、肛管静息压、肛管收缩压、直肠最大容量、并发症情况。结果:组间手术时间、术中出血量、术后排气时间比较,P>0.05,差异不明显。组间术后并发症以及肛肠功能指标比较,观察组均明显优于对照组,P<0.05。结论:虽然腹腔镜下直肠癌前切除术中不保留左结肠动脉可获得同保留接近的手术效果,但是就患者术后肛肠功能情况看,保留左结肠动脉更具优势。

Objective:To study the influence of the retention of the left colon artery in the laparoscopic anterior resection of rectal cancer on the anorectal function of patients,so as to provide a reference for the surgical treatment of rectal cancer patients.Methods:A total of 66 patients with rectal cancer received surgical treatment in our hospital from August 2018 to August 2019.The control group(n=33)that did not retain the left colonic artery during the operation and the observation group(n=33)that did not retain the left colonic artery during the operation were randomized.The operation time,intraoperative blood loss,postoperative exhaust time,postoperative anal function score,anal resting pressure,anal systolic pressure,rectal maximum volume and complications of patients undergoing laparoscopic anterior resection of rectal cancer were compared between the control group and the observation group.Results:The difference of operation time,intraoperative blood loss and postoperative exhaust time between groups was not significant at P>.05.Comparison of postoperative complications and anorectal function between groups showed that the observation group was significantly superior to the control group(P<0.05).Conclusion:Although laparoscopic anterior resection of rectal cancer without the retention of the left colonic artery can achieve a similar surgical effect,in terms of postoperative anorectal function,the retention of the left colonic artery is more advantageous.