腹腔镜直肠癌切除术中保留左结肠动脉术式的应用体会  

Effects of left colic artery reservation on laparoscopic colorectal surgery

作　　者：朱家明[1] 韩爱民[1] 郭云虎[1] Zhu Jiaming Han Aimin Guo Yunhu.(Department of Anorectal Surgery, Huaiyin Hospital of Huai＇an City, Huai＇an, Jiangsu, 223300, Chin)

机构地区：[1]淮安市淮阴医院肛肠科,江苏淮安223300

出　　处：《结直肠肛门外科》2016年第6期576-578,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨保留左结肠动脉对腹腔镜直肠癌切除术疗效的影响。方法选择本院2013年4月至2015年10月所收治63例直肠癌患者为研究对象,随机分为常规组(予传统腹腔镜下直肠癌切除术,n=32)和研究组(保留左结肠动脉的腹腔镜直肠癌切除术,n=31)。比较两组手术相关情况、术后吻合口漏发生情况及生活质量(KPS评分)。结果两组术中出血量、手术时间及清扫淋巴结数目比较,差异均无统计学意义(P﹥0.05);常规组预防性造口率为15.63%,研究组无预防性造口病例,组间差异有统计学意义(P﹤0.05)。常规组吻合口漏发生率为12.50%,研究组无吻合口漏病例,差异有统计学意义(P﹤0.05)。治疗前,两组KPS评分差异无统计学意义(P﹥0.05);治疗后,研究组KPS评分升至(88.18±5.32)分,显著高于常规组水平,差异有统计学意义(P﹤0.05)。结论与传统腹腔镜下直肠癌切除术相比,保留左结肠动脉的术式并未增加手术时间及术中出血量及清扫淋巴结数目相当,可减少预防性造口率及术后吻合口漏发生率,更利于提高患者术后生活质量。Objective To investigate the effect of left colic artery reservation on laparoscopic colorectal cancer.Methods Clinical data of 63 patients of colorectal cancer treated in our hospital from Arpil 2013 to October 2015 were analyzed retrospectively.They were divided into treatment group（n=31） and control group（n=32）.Patients in control group received traditional laparoscopic colorectal surgery,and those in treatment group received laparoscopic colorectal resection with left colic artery reserved.Comparisons were performed between the two groups regarding intraoperative and postoperative indicators.Results There was no significant difference between the two groups in terms of intraoperative blood loss,operation time and number of dissected lymph node（P〉0.05）.Anastomotic fistula and preventive stoma were significantly less in treatment group than those in control group（P〈0.05）.KPS scores before treatment were comparable between the two groups（P〉0.05）.In treatment group,postoperative KPS score increased to（88.1 ± 5.3）,which was significantly higher than that of the control group（82.7 ± 4.9）（P〈0.05）.Conclusions Laparoscopic colorectal surgery with left colic artery reserved does not affect the operation time,and blood loss,the number of dissected lymph node.However,it reduces incidence of postoperative anastomotic leakage and preventive stoma and improves quality of life.

关 键 词：左结肠动脉 腹腔镜 直肠癌 

分 类 号：R735.37[医药卫生—肿瘤]