直肠癌根治术中保留左结肠动脉的临床价值

The Clinical Value of Preserving the Left Colon Artery during Radical Resection of Rectal Cancer

目的研究直肠癌根治术中保留患者左结肠动脉的临床价值。方法选取2016年1月—2021年7月该院收治的81例直肠癌患者为研究对象,分为对照组(41例)和观察组(40例),所有患者采用开放或腔镜手术,对照组不保留左结肠动脉,观察组保留左结肠动脉,两组手术均由同组医师完成操作。对比两组围术期指标、并发症情况及手术前后生存质量评分。结果与对照组比较,观察组手术时间更长,首次排气时间、住院时间均更短,术中出血量更低,差异有统计学意义(t=2.367、40.636、3.744、4.439,P<0.05);观察组术后生活质量评分30(QOL-30)评分为(79.89±2.62)分,高于对照组(71.39±2.49)分,差异有统计学意义(t=14.969,P<0.05)。结论直肠癌根治术中保留患者左结肠动脉的疗效与不保留左结肠动脉相当,对患者近期疗效无明显影响,有利于提高患者生存质量,且可改善患者近端肠管血运,降低吻合口瘘及预防性造口的比例。

Objective To study the clinical value of preserving the left colon artery in patients undergoing radical resection of rectal cancer.Methods 81 patients with rectal cancer admitted to the hospital from January 2016 to July 2021 were selected as the research objects,and they were divided into a control group(41 cases)and an observation group(40 cases).All patients underwent open or laparoscopic surgery.The left colon artery was not retained in the control group,and the left colon artery was retained in the observation group.Both groups of operations were performed by the same group of physicians.The perioperative indicators,complications and quality of life scores before and after the operation were compared between the two groups.Results Compared with the control group,the observation group had longer operation time,shorter first exhaust time,shorter hospital stay,and lower intraoperative blood loss,the difference was statistically significant(t=2.367,40.636,3.744,4.439,P<0.05).The postoperative QLQ-30 score of the observation group was(79.89±2.62)points,which was higher than the control group(71.39±2.49)points,and the difference was statistically significant(t=14.969,P<0.05).Conclusion The curative effect of preserving the left colon artery during radical resection of rectal cancer is equivalent to that of not preserving the left colon artery.It has no obvious effect on the patient's short-term curative effect,and is beneficial to improve the patient's quality of life.And it can improve the blood supply of the patient's proximal bowel,and reduce the proportion of anastomotic leakage and preventive stoma.