腹腔镜下直肠癌根治术中保留左结肠动脉的临床研究

Clinical research of preserving left colon artery in laparoscopic rectal cancer resection

目的探讨腹腔镜下直肠癌根治术中保留左结肠动脉的临床研究。方法选取2018年5月~2020年5月在我院行腹腔镜下直肠癌根治术的患者100例,按LCA结果分为观察组和对照组,每组各50例。观察组术中保留LCA,低位结扎肠系膜下动脉(IMA);对照组术中不保留LCA,高位结扎肠系膜下动脉(IMA)。比较两组患者术后病理结果、围手术期相关指标、术后并发症发生情况。结果两组术后病理结果(包括TNM分期及第3站淋巴结转移率)比较,差异无统计学意义(P>0.05)。两组术中淋巴结清扫数、手术时间和术中出血量比较,差异均无统计学意义(P>0.05);观察组的术后肛门排气时间、住院时间低于于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为16.0%,低于对照组的34.0%,差异有统计学意义(P<0.05)。结论腹腔镜下直肠癌根治术中保留LCA,能缩短住院时间,降低术后并发症发生率,淋巴清扫效果满意且不会增加手术难度,值得临床推广。

Objective To investigate the clinical research of preserving left colon artery(LCA)in laparoscopic rectal cancer resection.Methods A total of 100 patients treated with laparoscopic rectal cancer resection in our hospital from May 2018 to May 2020 were selected and divided into the observation group(n=50)and the control group(n=50)according to LCA results.LCA was preserved in the observation group during operation and inferior mesenteric artery(IMA)was ligated at low position,while LCA wasn’t preserved in the control group during operation and IMA was ligated at high position.The postoperative pathological results,perioperative indexes and postoperative complications of the two groups were compared.Results There were no statistically significance differences(P>0.05)in the postoperative pathological data between the two groups,including TNM staging and statistical results of lymph node metastasis rate at stage 3.There was no statistically significant difference in lymph node dissection,operation time and intraoperative hemorrhage between the two groups(P>0.05).The postoperative anal exhaust time and hospitalization time of the observation group were lower than those of the control group(P<0.05).The incidence of complications in the observation group was 16.0%,which was lower than that 34.0%in the control group.There was statistically significant difference between the two groups(P<0.05).Conclusion The preserving LCA in laparoscopic of rectal cancer resection can shorten the hospitalization time and reduce postoperative complication,with satisfied lymphatic dissection efficacy and without increasing the difficulty of operation,and is worthy of clinical promotion.