肠系膜下动脉根部结扎在直肠癌前切除术中的应用  

The application of observation for the Root Ligation of Inferior Mesenteric Arterial in rectal cancer resection

作　　者：黄斌[1] 陈继贵 吴揭 程乔[1] 

机构地区：[1]松滋市中医院,湖北松滋434200 [2]武汉市八医院,湖北武汉430010

出　　处：《结直肠肛门外科》2013年第2期84-86,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨肠系膜下动脉(IMA)根部结扎对直肠癌根治术的临床应用价值。方法将2003年1月至2007年12月收治的173例直肠癌前切除术患者随机分成两组,其中根部结扎组85例,采用IMA根部结扎术及根部淋巴结廓清,非根部结扎组88例,采用IMA低位结扎及结扎部位淋巴结廓清。根部结扎组,比较两组患者的平均手术时间、淋巴结数及转移度、复发率、5年生存率、并发症发生率。结果非根部结扎组的淋巴结数、淋巴结转移度、术后生存率明显低于根部结扎组,复发率则明显高于根部结扎组(P<0.05);两组手术时间、并发症比较,差异无统计学意义(P>0.05)。结论 IMA根部结扎及根部淋巴结廓清对直肠癌的治疗效果优于IMA非根部结扎及结扎部位淋巴结廓清,值得推广应用。Objective To explore the clinical application value of the Inferior Mesenteric Artery （IMA） root ligation in colorectal cancer radical resection. Methods Analysised 173 patients with rectal cancer re-section who cured in our hospital since January. 2003 to December. 2007. 85 cases treat with the ligation of IMA （hereinafter referred to as the root ligation group）, and 88ease treat with the root of non ligation （hereinafter referred to as the root of non ligation group） . The root of the non ligation group use IMA low ligation and the lymph node dissection on the ligation postion; Root ligation group adopts the root of the IMA ligation and the lymph node dissection. Compare and statistical analysis the average operating time of the two groups,the count of lymph node and the transfer rate, recurrence rate. the 5 years survival rate and the incidence of complications. Results The count of lymph node,the lymph node transfer rate and the postoperative survival rate in the non ligation is less than ligation group; the recurrence in the root of non ligation group is higher than the root ligation group, （ P 〈0.05）; Compare with the operating time and the incidence of complications in two group, there was no statistically significant difference （ P 〉0. 05）. Conclusion The effect of the root ligation of the IMA and the lymph node dissection to colorectal cancer treatment is better than the root of the IMA with non ligation and the lymph node dissection on the liga-tion postion. It is worthy of popularization and application.

关 键 词：肠系膜下动脉 根部结扎 直肠癌前切除术 

分 类 号：R735.37[医药卫生—肿瘤]