腹腔镜结直肠癌根治术保留直肠上动脉与传统高位离断肠系膜下动脉的效果比较

Curative effect of superior rectal artery preservation and traditional high-position dissection of inferior mesenteric artery on patients undergoing laparoscopic radical resection of colorectal cancer

目的比较腹腔镜结直肠癌根治术保留直肠上动脉与传统高位离断肠系膜下动脉的效果。方法对焦作煤业(集团)有限责任公司中央医院2016年7月至2019年7月100例结直肠癌患者的临床资料进行回顾性分析,所有患者均接受腹腔镜根治术,根据手术方法分为A组(47例)和B组(53例),A组保留直肠上动脉,B组传统高位离断肠系膜下动脉。比较两组手术情况、术后胃肠功能恢复情况、并发症、转移及复发情况。结果A组手术时间长于B组(P<0.05);两组腹腔引流量、术中出血量、切口长度、清扫淋巴结数量、住院时间比较,差异未见统计学意义(P>0.05);A组术后排气恢复时间、排便恢复时间短于B组(P<0.05);A组吻合口相关并发症发生率(6.38%)低于B组(20.75%,P<0.05);两组肠梗阻、排尿功能障碍发生率比较,差异未见统计学意义(P>0.05);随访1年,两组转移率及复发率比较,差异未见统计学意义(P>0.05)。结论保留直肠上动脉与传统高位离断肠系膜下动脉在腔镜结直肠癌根治术中的疗效相当,但保留直肠上动脉能缩短术后胃肠功能恢复时间,减少吻合口相关并发症。

Objective To compare the curative effect of superior rectal artery(SRA)preservation and traditional high-position dissection of inferior mesenteric artery(IMA)on patients undergoing laparoscopic radical resection of colorectal cancer.Methods The clinical data of 100 patients with colorectal cancer in Central Hospital of Jiaozuo Coal Industry Group from July 2016 to July 2019 were retrospectively analyzed.All underwent laparoscopic radical resection.According to different surgical methods,they were divided into group A(n=47)and group B(n=53).Group A underwent SRA preservation,while group B underwent traditional high-position IMA dissection.The surgical situations,postoperative recovery of gastrointestinal function,complications,metastasis and recurrence were compared between the two groups.Results The operation time in group A was longer than that in group B(P<0.05).There were no significant differences in abdominal drainage volume,intraoperative blood loss,incision length,number of lymph nodes dissection and hospitalization time between the two groups(P>0.05).After surgery,recovery time of exhaust and defecation in group A were shorter than those in group B(P<0.05).The incidence of anastomosis related complications in group A was lower than that in group B(6.38%vs.20.75%),P<0.05.There was no significant difference in the incidence of intestinal obstruction and urinary dysfunction between the two groups(P>0.05).After 1-year of follow-up,there were no significant differences in metastasis rate and recurrence rate between the two groups(P>0.05).Conclusions The curative effect of SRA preservation and traditional high-position IMA dissection is comparable in laparoscopic radical resection of colorectal cancer.However,the former can shorten postoperative recovery time of gastrointestinal function,and reduceanastomosis related complications.