直肠癌肠系膜下动脉高位结扎对保留盆腔植物神经的临床研究  

High ligation of the inferior mesenteric artery with autonomic nerve preservation in rectal cancer surgery

作　　者：杨开焰[1] 陈道瑾[1] 李小荣[1] 吴唯[1] 

机构地区：[1]中南大学湘雅三医院普外科,湖南长沙410013

出　　处：《中国现代医学杂志》2010年第10期1551-1553,1556,共4页China Journal of Modern Medicine

摘　　要：目的探讨直肠癌根治术中肠系膜下动脉高位结扎对保留男性盆腔植物神经的影响。方法回顾性分析中南大学湘雅三医院普外科2005年1月～2006年12月DukesB、C期直肠癌患者病例资料。其中,结扎组46例行肠系膜下动脉高位结扎的直肠癌根治术保留盆腔植物神经,另外17例(DukesB、C期)行单纯直肠癌根治术为对照组。结果肠系膜下动脉高位结扎组和对照组病人术后排尿功能障碍的总发生率分别为8.6%(4/46)、41.2%(7/17);术后勃起功能障碍的发生率分别为32.6%(15/46)、82.3%(13/17);术后射精功能障碍的发生率分别为21.7%(10/46)、64.7%(11/17),差异均有显著性(P<0.05)。肠系膜下动脉高位结扎组和对照组的局部复发率为6.5%(3/46)和11.8%(2/17),差异无显著性(P>0.05)。结论直肠癌根治术中肠系膜下动脉高位结扎,能够有效地保留盆腔植物神经的功能,提高病人术后的生活质量。[Objective]To evaluate high ligation of the inferior mesenteric artery for rectal cancer in the preservation of the autonomic nerve in rectal cancer surgery and protection of postoperative urinary and male sexual functions.[Methods]46 Dukes B and C cases underwent high ligation of the inferior mesenteric artery for radical resection of rectal cancer. Result was compared with that of 17 cases undergoing traditional radical operation.[Results]The urinary dysfunction rate were 8.6% （4/46） and 41.2% （7/17） in case and control group,and was found significant difference （P 0.05）. The erectile dysfunction rate were 32.6% （15/46） and 82.3% （13/17） in case and control group,and was found significant difference（P 0.05）. 21.7% （10/46） and 64.7% （11/17） of ejaculatory disorder in the two groups and had significance （P 0.05）. No significant difference was found in local recurrence between case and control group（P 0.05）.[Conclusion]High ligation of the inferior mesenteric artery for radical resection of rectal cancer is effective to reduce the postoperative urinary and sexual dysfunction while maintaining the radical cure for the cancer.

关 键 词：直肠肿瘤 肠系膜下动脉 盆腔植物神经 

分 类 号：R735.37[医药卫生—肿瘤]