腹腔镜直肠癌根治术中保留左结肠动脉应用于老年直肠癌患者的临床疗效评估

Clinical evaluation of preserving left colonic artery in laparoscopic radical resection of rectal cancer in elderly patients with rectal cancer

目的探讨在老年直肠癌患者腹腔镜手术中将左结肠动脉精准保留的临床效果。方法选取2017年5月至2021年8月于无锡市中医医院就诊的老年直肠癌患者68例为研究对象,根据不同手术方式分为对照组30例(术中不保留左结肠动脉)、试验组38例(术中保留左结肠动脉),比较两组患者手术指标、术后恢复情况。结果试验组与对照组患者术中出血量(P=0.774)、清扫淋巴结总数量(P=0.642)、第253组淋巴结清扫数量(P=0.571)及吻合口出血(P=0.865)无显著差异(P>0.05),但试验组患者手术时间更长(P=0.003),术后住院时间、肛门通气时间较对照组短(P分别为0.006、0.001),吻合口漏发生率也低于对照组(P=0.046)。结论对于老年直肠癌患者,在腹腔镜根治术的过程中保留左结肠动脉,对于淋巴结清扫效率没有造成负面的影响,且出血风险也未增加,同时能够有效缩短术后排气时间,降低吻合口漏发生率。

Objective To investigate the clinical effect of precise preservation of left colonic artery in laparoscopic surgery in elderly patients with rectal cancer.Method 68 elderly patients with rectal cancer treated in Wuxi traditional Chinese medicine hospital from May 2017 to August 2021 were selected as the research object.According to different operation methods,they were divided into 30 cases in the control group(without retaining the left colonic artery during operation)and 38 cases in the experimental group(retaining the left colonic artery during operation).The operation indexes and postoperative recovery of the two groups were compared.Result There was no significant difference in intraoperative bleeding(P=0.774),total number of lymph nodes cleaned(P=0.642),number of lymph nodes cleaned(P=0.571)and anastomotic bleeding(P=0.865)between the experimental group and the control group(P>0.05),but the operation time of the experimental group was longer(P=0.003),the postoperative hospital stay and anal ventilation time were shorter than those of the control group(P=0.006 and 0.001 respectively),and the incidence of anastomotic leakage was also lower than that of the control group(P=0.046).Conclusion For elderly patients with rectal cancer,preserving the left colonic artery during laparoscopic radical resection has no negative impact on the efficiency of lymph node dissection,and the risk of bleeding has not increased.At the same time,it can effectively shorten the postoperative exhaust time and reduce the incidence of anastomotic leakage.