腹腔镜直肠癌前切除术中保留左结肠动脉与否的临床疗效对照研究

A Control Study of the Clinical Effects of Reserving Versus Unreserving Left Colonic Artery in Laparoscopic Anterior Resection of Rectal Cancer

目的探讨腹腔镜直肠癌前切除术中保留左结肠动脉对手术疗效的影响。方法选取我院2010年1月至2018年10月收治的腹腔镜直肠癌前切除术患者106例,根据保留左结肠动脉与否分成保留组(n=52)与不保留组(n=54),比较两组的围术期指标及预后。结果两组的术中出血量比较,差异无统计学意义(P>0.05);保留组的手术时间显著长于不保留组,术后排气时间与住院时间均显著短于不保留组(P<0.05)。术后3个月,保留组的Wexner评分显著低于不保留组(P<0.05)。两组的术后吻合口瘘发生率和复发率比较,差异无统计学意义(P>0.05)。结论腹腔镜直肠癌前切除术中保留左结肠动脉会增加手术操作时间,但不增加手术创伤及复发率,能促进术后肠道功能的恢复。

Objective To explore the impact of reserving left colonic artery in laparoscopic anterior resection of rectal cancer on the surgical efficacy.Methods 106 patients with laparoscopic anterior resection of rectal cancer admitted to our hospital from January 2010 to October 2018 were selected and divided into the reserved group(n=52)and the unreserved group(n=54)according to whether the left colonic artery was reserved.The perioperative indicators and prognosis were compared between two groups.Results No statistical difference was found between two groups in the intraoperative blood loss amount(P>0.05);The operation time of the reserved group was significantly longer than that of the unreserved group,and the postoperative anal exhaust time and hospitalization time were significantly shorter than those of the unreserved group(P<0.05).3 months after surgery,the Wexner score of the reserved group was significantly lower than that of the unreserved group(P<0.05).No statistical difference was found between two groups in the incidence of postoperative anastomotic fistula and recurrence rate(P>0.05).Conclusions Rreserving left colonic artery in laparoscopic anterior resection of rectal cancer will increase the operation time,but does not increase surgical trauma and recurrence rate,and can promote the recovery of postoperative intestinal function.