腹腔镜下直肠癌根治术中保留左结肠动脉对患者预后的临床研究

A clinical study on the prognosis of patients undergoing laparoscopic radical resection of rectal cancer by preserving the left colon artery

目的探索直肠癌根治术中保留左结肠动脉的临床意义。方法回顾性纳入2019年2月至2023年2月期间本院收治的74例直肠癌患者资料,按照术中是否保留左结肠动脉划分为观察组(术中保留左结肠动脉)和对照组(术中不保留左结肠动脉)各37例,分析对比其临床资料。结果观察组手术时间(151.54±12.73)min较对照组(143.84±11.89)min长,差异有统计学意义(P<0.05);观察组住院时间(12.21±1.53)d较对照组(14.95±1.71)d短,差异有统计学意义(P<0.05);术后观察组胃肠功能评分(97.31±8.54)优于对照组(93.02±9.01),差异有统计学意义(P<0.05);观察组术后CRP(44.32±5.51)mg/mL、IL-6(95.84±8.94)ng/mL及TNF-α(9.54±0.84)pg/mL水平均低于对照组[(51.35±6.21)mg/mL、(104.28±10.57)ng/mL、(10.89±1.01)pg/mL],差异有统计学意义(P<0.05);观察组术后并发症发生率(5.41%)显著低于对照组(21.62%),差异有统计学意义(P<0.05)。结论本研究表明腹腔镜下直肠癌根治术中保留左结肠动脉不仅可以降低术后患者炎症反应,加快术后恢复,还有助于减少患者术后发生吻合口瘘等并发症的风险,有利于提高患者预后。

Objective To explore the clinical significance of preserving the left colon artery during radical resection of rectal cancer Methods A retrospective review was conducted on the data of 74 patients with rectal cancer admitted to our hospital from February 2019 to February 2023.They were divided into the observation group(with left colon artery preserved during surgery)and the control group(without left colon artery preserved during surgery),with 37 cases in each group.The clinical data were analyzed and compared.Results The surgical time in the observation group(151.54±12.73 minutes)was longer than that in the control group(143.84±11.89 minutes),and the difference was statistically significant(P<0.05).The hospitalization time in the observation group(12.21±1.53 days)was shorter than that in the control group(14.95±1.71 days),and the difference was significant(P<0.05).The postoperative gastrointestinal function score(97.31±8.54)in the observation group was better than that in the control group(93.02±9.01),with statistical significance(P<0.05).The levels of postoperative CRP(44.32±5.51 mg/mL),IL-6(95.84±8.94 ng/mL),and TNF-α(9.54±0.84 pg/mL)in the observation group were lower than those in the control group(51.35±6.21 mg/mL,104.28±10.57 ng/mL,10.89±1.01 pg/mL),and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group(5.41%)was significantly lower than that in the control group(21.62%),and the difference was statistically significant(P<0.05).Conclusion This study demonstrates that preserving the left colon artery during laparoscopic radical resection of rectal cancer can not only reduce postoperative inflammation and accelerate postoperative recovery,but also help reduce the risk of postoperative complications such as anastomotic leakage,which is beneficial for improving patient prognosis.