保留左结肠动脉腹腔镜全直肠系膜切除术对中低位直肠癌患者术后恢复及并发症的影响

Effect of laparoscopic total mesorectal excision of left colon artery on postoperative recovery and complications in patients with middle and low rectal cancer

目的探讨保留左结肠动脉腹腔镜全直肠系膜切除术对中低位直肠癌患者术后恢复及并发症的影响。方法选取2018年1月至2019年10月本院收治的97例直肠癌患者,根据手术方法的不同分为对照组(n=48)和观察组(n=49)。对照组行不保留左结肠动脉腹腔镜全直肠系膜切除术,观察组行保留左结肠动脉腹腔镜全直肠系膜切除术。比较两组围术期指标、肠系膜根部下淋巴结清扫情况、并发症发生率及吻合口瘘发生率。结果观察组手术时间、肛门排气时间、住院时间、肠系膜根部下淋巴结清扫时间均短于对照组,术中出血量少于对照组,淋巴结清扫数目多于对照组,吻合口瘘发生率低于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为6.12%,与对照组的14.58%比较差异无统计学意义。结论中低位直肠癌患者采用保留左结肠动脉腹腔镜全直肠系膜切除术效果显著,可有效缩短患者手术时间,降低术中出血量,提高肠系膜根部下淋巴结清扫效率,并促进患者术后恢复,减少吻合口瘘的发生。

Objective To investigate the effect of laparoscopic total mesorectal excision of left colon artery on postoperative recovery and complications in patients with middle and low rectal cancer.Methods 97 patients with rectal cancer from January 2018 to October 2019 were selected and they were divided into control group(n=48)and observation group(n=49)according to different surgical methods.The control group underwent laparoscopic total mesorectal excision without preserving left colonic artery,and the observation group underwent laparoscopic total mesorectal excision with preservation of left colon artery.The perioperative indexes,lymph node dissection,incidence of complications and anastomotic leakage were compared between the two groups.Results The surgical time,anal exhaust time,hospitalization time of the observation group were shorter than the control group,intraoperative blood loss was less than that of the control group,the number of lymph node dissection was more than that of the control group,and the incidence of anastomotic leakage was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion It was effective in middle and low rectal cancer,which can reduce the operation time,improve the efficiency of lymph node cleaning and promote postoperative recovery and reduce the occurrence of anastomotic fistula.