摘要
目的探讨腹腔镜下直肠癌根治术中根据肠系膜下动脉不同分型精准保留左结肠动脉及根部淋巴结清扫的治疗效果。方法2019年1月~2022年1月我院收治的直肠癌病人80例,按照信封随机分组法,将80例病人随机分为观察组以及对照组,每组各40例,观察组根据病人肠系膜分型情况,精准开展低位结扎手术,对照组采取传统高位结扎手术。比较两组病人的围手术期指标、并发症、胃肠道功能、胃泌素以及胃动素之间的差异。结果两组病人手术时间、术中出血量、排气时间以及淋巴结阳性率比较,差异无统计学意义(P>0.05);观察组病人淋巴结清扫数量为(24.27±5.92)枚,对照组为(16.12±5.99)枚,两组比较差异有统计学意义(P<0.05);两组病人排尿困难、吻合口出血及吻合口漏发生率比较,差异无统计学意义(P>0.05);两组病人的肠鸣音恢复时间以及开始进食时间比较,差异无统计学意义(P>0.05);手术后,两组病人的胃泌素以及胃动素水平均显著下降,但观察组的胃泌素为(133.33±16.14)pg/ml,胃动素为(318.33±24.11)pg/ml,显著高于对照组的(114.78±15.97)pg/ml和(287.44±23.09)pg/ml,差异有统计学意义(P<0.05)。结论腹腔镜下直肠癌根治术中基于肠系膜下动脉分型的精准保留左结肠动脉及根部淋巴结清扫手术安全可行,病人淋巴结清扫数目显著提升,术后胃肠功能恢复快。
Objective To investigate the effect of laparoscopic radical resection of rectal cancer by reserving the left colon artery and root lymph node accurately according to different types of inferior mesenteric artery.Methods In this study,80 cases of rectal cancer patients diagnosed and treated from January 2019 to January 2022 were selected as the research objects.According to the envelope random grouping method,the above patients were randomly divided into observation group and control group,with 40 cases in each group.According to the intestinal mesenteric classification of patients,the observation group carried out precise low ligation operation,while the control group adopted traditional high ligation operation.The perioperative indexes,complications,gastrointestinal function,gastrin and motilin were compared between the two groups.Result There was no significant difference in operation time,intraoperative blood loss,exhaust time and lymph node positive rate between the two groups(P>0.05),and the number of lymph node dissection in the observation group(24.27±5.92)was significantly higher than that in the control group(16.12±5.99),there was significant difference(P<0.05).There was no significant difference in dysuria,anastomotic bleeding and anastomotic leakage between the two groups(P>0.05).There was no significant difference between the recovery time of bowel sounds and the time of eating(P>0.05).After operation,the gastrin and motilin water in the two groups decreased significantly,but the gastrin[(133.33±16.14)pg/ml]and motilin(318.33±24.11)pg/ml in the observation group were significantly higher than that of the control group[(114.78±15.97)pg/ml,(287.44±23.09)pg/ml],the difference was statistically significant(P<0.05).Conclusion Laparoscopic radical resection of rectal cancer according to the different types of inferior mesenteric artery accurately retain the left colon artery and root lymph node dissection,postoperative gastrointestinal function and lymph node dissection significantly improved,for the prognosis of patients with positive significance.
作者
司宇光
吴国庆
裴炜
SI Yuguang;WU Guoqing;PEI Wei(Department of SurgicalⅠ.Beijing Huairou Hospital of Traditional Chinese Medicine,Beijing 101400,China)
出处
《临床外科杂志》
2023年第12期1167-1170,共4页
Journal of Clinical Surgery