腹腔镜结直肠癌手术中肠系膜下动脉及其主要属支处理

Management of the inferior mesenteric artery and its major branches in laparoscopic colorectal cancer surgery

发生于结肠脾曲、降结肠、乙状结肠和直肠等部位的肿瘤切除手术均涉及肠系膜下动脉及其主要属支的处理,为清扫肠系膜根部淋巴结而一律切除肠系膜下动脉的做法常带来吻合口灌注不足等一系列问题,影响远近期预后;通过精细解剖、精准切除,保留肠系膜下动脉及其主要属支,切除系膜根部淋巴结,保证手术根治性的同时避免了切除肠系膜下动脉带来的种种弊端,可望改善部分结直肠癌病人预后。

The surgical resection of tumors occurring in anatomical regions such as the splenic flexure of the colon,descending colon,sigmoid colon,and rectum involves the manipulation of the inferior mesenteric artery and its major branches.The practice of universally excising the inferior mesenteric artery to clear mesenteric root lymph nodes introduces many issues,including insufficient anastomotic perfusion,affecting both short-term and long-term prognoses.Through meticulous anatomical dissection and precise excision,preserving the inferior mesenteric artery and its principal branches,while excising lymph nodes at the root of the mesentery,avoids various drawbacks associated with inadequate mesenteric artery resection without compromising the curative nature of the surgery.This approach holds the potential to improve the prognosis of patients with colorectal cancer.