腹腔镜保留直肠上血管乙状结肠癌根治术的近期疗效  

Short-term curative effect of superior rectal artery preserving laparoscopic resection of sigmoid coloncarcinoma

作　　者：汤小龙 曲辉[1] 何庆泗[1] 孙国瑞[1] 张昊 赵恩生 

机构地区：[1]山东大学齐鲁医院普外科,济南250012

出　　处：《中华普通外科杂志》2018年第1期30-33,共4页Chinese Journal of General Surgery

基　　金：山东省自然科学基金资助项目（ZR2014HQ044）

摘　　要：目的探讨保留直肠上血管的乙状结肠癌手术的具体操作技术和可行性。方法回顾性分析2015年1月至2016年11月接受腹腔镜乙状结肠癌根治术的85例患者．其中保留血管组27例行保留直肠上动脉的乙状结肠癌根治术，传统术式组58例行不保留直肠上血管的根治术。结果保留血管组术中平均出血量为（62±17）m1，传统术式组为（67±17）ml，两组相比差异无统计学意义（t=1．370，P〉0．05）；两组在淋巴结清扫数目方面相比差异无统计学意义[（15±8）个比（15±7）个，t=0．058，P〉0．05]；保留血管组手术时间长于传统术式组[（283±51）min比（179±63）min，t=7．530，P〈0．05]，差异有统计学意义；保留血管组患者均未发生吻合口漏，传统术式组有2例发生吻合口漏，两组相比差异无统计学意义（X2=0．043，P〉0．05）。结论保留直肠上血管的乙状结肠癌根治术是安全可行的。Objective To study the operational techniques and feasibility of superior rectal artery preserving laparoscopic resection of sigmoid colon carcinoma. Methods From Jan 2015 to Nov 2016, 85 patients with sigmoid colon carcinoma were divided into artery preserving group （27 cases ） and traditional surgical group （58 cases）. Results The mean operation time was （283 ± 51 ） min, the mean lymph node dissection was （ 15 ± 8） and the mean blood loss was （62 ± 17 ） ml in the artery preserving group. The mean operation time was （179 ±63） min, the mean lymph node dissection was （15 ±7） and the mean blood loss was （67 ±17） ml in the traditional surgery group. The number of resected lymph nodes and blood loss had no statistical significance between these two groups （t = 0. 058, P 〉 0. 05 ）. Longer operating time were observed in the retained vascular group as compared to the traditional surgical group （ t = 7. 530, P 〈 0. 05）. There was no anastomotic fistula in the retained vascular group, however, two anastomotic fistula cases occurred in the traditional surgical group （X2 = 0. 043, P 〉 0. 05）. Conclusions Preservation of superior rectal artery was safe and feasible for laparoscopic resection of sigmoid colon carcinoma.

关 键 词：乙状结肠肿瘤 结肠切除术 腹腔镜 直肠上动脉 

分 类 号：R735.35[医药卫生—肿瘤]