左结肠动脉保留在腹腔镜下直肠癌根治术中的临床价值

Clinical value of left colic artery preservation in laparoscopic radical resection of rectal cancer

目的 探讨腹腔镜下直肠癌根治术中保留左结肠动脉的临床价值。方法 回顾性分析我院行腹腔镜下直肠癌根治术的93例直肠癌患者的临床资料,将术中保留左结肠动脉的48例患者纳入保留组,术中未保留左结肠动脉的45例患者纳入未保留组。比较2组患者围术期相关指标、并发症发生情况及术后1、2、3年生存率。结果 与未保留组比较,保留组患者首次肛门排气时间、肠鸣音恢复时间及首次进食时间缩短,术中失血量减少,手术时间延长,差异均有统计学意义(P<0.05);2组患者淋巴结清扫数比较差异无统计学意义(P>0.05)。2组术后并发症发生率及术后1、2、3年生存率比较,差异均无统计学意义(P>0.05)。结论腹腔镜下直肠癌根治术中保留左结肠动脉可减少术中出血量,促进患者术后胃肠功能恢复,且不会增加并发症,更符合人体解剖学结构理念。

To investigate the clinical value of left colic artery preservation in laparoscopic radical resection of rectal cancer.Methods The clinical data of 93 patients with rectal cancer who underwent laparoscopic radical resection of rectal cancer in our hospital were retrospectively analyzed,and 48 cases with intraoperative preservation of the left colonic artery during surgery were included in the preservation group,and 45 patients without intraoperative preservation of the left colonic artery during surgery were included in the non-preservation group.The perioperative indexes,occurrence of complications,and 1-year,2-year,3-year survival rates of patients after operation in the two groups were compared.Results Compared with the non-preservation group,the time to the first anal exhaust,the recovery time of bowel sounds and first feeding time of patients were shortened,the intraoperative blood loss was decreased,and the operation time was prolonged,with statistically significant differences(P<0.05).There was no statistically significant difference in the number of lymph node dissection of patients between the two groups(P>0.05).There was no statistically significant difference in the incidence of postoperative complications or 1-year,2-year,3-year survival rates of patients after operation between the two groups(P>0.05).Conclusion Laparoscopic radical resection of rectal cancer with left colic artery preservation can reduce the intraoperative blood loss,promote the recovery of gastrointestinal function after surgery,without the increase of complications,which is more in line with the concept of human anatomical structure.