腹腔镜直肠癌根治术中保留左结肠动脉的临床研究

Clinical Study on Preservation of Left Colic Artery in Laparoscopic Radi⁃cal Resection of Rectal Cancer

目的探讨腹腔镜直肠癌根治术中保留左结肠动脉(left colonic artery,LCA)的临床效果。方法随机选择2020年6月—2022年6月贵州省兴义市人民医院收治的80例腹腔镜直肠癌根治术患者为研究对象,根据术中是否保留LCA分为对照组(不保留LCA)与观察组(保留LCA),每组40例。比较两组手术指标、术后并发症、随访1年生存率,以及术前与术后3个月胃肠功能、排尿功能。结果两组手术指标(手术时间、出血量、住院时间)比较,差异无统计学意义(P>0.05)。观察组术后并发症率为5.00%,明显低于对照组的25.00%,差异有统计学意义(χ^(2)=6.275,P=0.012)。两组随访1年生存率比较,差异无统计学意义(P>0.05)。术后3个月,观察组胃肠道生活质量指数表(Gastrointestinal Quality of Life Index,GIQLI)评分高于对照组,而膀胱过度活动症状评分表(Bladder Overactivity Symptom Scale,OABSS)评分低于对照组,差异有统计学意义(P<0.05)。结论针对腹腔镜直肠癌根治术患者,相比不保留LCA而言,术中保留LCA在手术指标与随访1年生存率上无明显差异,但能减少术后并发症发生,而且能更好地改善患者的排尿功能与胃肠功能,有应用价值。

Objective To explore the clinical effect of preserving the left colonic artery(LCA)during laparoscopic radical resection of rectal cancer.Methods 80 patients who underwent laparoscopic radical resection of rectal cancer admitted to Xingyi People′s Hospital in Guizhou Province from June 2020 to June 2022 were randomly selected as the research subjects.They were divided into a control group(without LCA preservation)and an observation group(with LCA preservation)based on whether LCA was preserved during the surgery,with 40 patients in each group.The surgical indicators,postoperative complications,1-year follow-up survival rate,gastrointestinal function and urinary function before operation and 3 months after operation were compared between the two groups.Results When comparing the surgical indicators(operation time,blood loss,and hospitalization time)between the two groups,there was no statistically significant difference(P>0.05).The postoperative complication rate in the observation group was 5.00%,significantly lower than the 25.00%in the control group,and the difference was statistically significant(χ^(2)=6.275,P=0.012).There was no statistically significant difference in the 1-year survival rate between the two groups(P>0.05).Three months after surgery,the Gastrointestinal Quality of Life Index(GIQLI)score of the observation group was higher than that of the control group,while the Bladder Overactivity Symptom Scale(OABSS)score was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion For patients undergoing laparoscopic radical resection of rectal cancer,compared with those without LCA preservation,there is no significant difference in surgical indicators and 1-year follow-up survival rate between LCA preservation during surgery.However,it can reduce the occurrence of postoperative complications and better improve the patient′s urinary function and gastrointestinal function,so it has practical value.