保留左结肠动脉及直肠上动脉的腹腔镜乙状结肠癌根治术的临床应用及近期疗效分析  

Clinical application and short-term curative effect analysis in preservation of left colon artery and superior rectal artery for the laparoscopic resection of sigmoid colon carcinoma

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,山东济南250012

出　　处：《腹腔镜外科杂志》2017年第12期903-906,共4页Journal of Laparoscopic Surgery

基　　金：山东省自然科学基金资助项目(编号:ZR2014HQ044)

摘　　要：目的:探讨保留左结肠动脉及直肠上动脉的乙状结肠癌手术的具体操作技术及临床可行性,并与传统术式进行对比。方法:回顾分析2015年1月至2016年11月为82例患者行腹腔镜乙状结肠癌根治术的临床资料,将患者分为保留血管组(n=24)与传统术式组(n=58)。保留血管组行保留左结肠动脉及直肠上动脉的乙状结肠癌根治术,传统术式组行不保留上述血管的根治术。比较两组手术时间、淋巴结清扫数量、术中出血量、吻合口愈合情况等指标。结果:两组淋巴结清扫数量差异无统计学意义(P>0.05);保留血管组手术时间长于传统术式组,差异有统计学意义(P<0.05);保留血管组患者未发生吻合口瘘,传统组发生2例,差异无统计学意义(P>0.05)。结论:保留左结肠动脉及直肠上动脉的腹腔镜乙状结肠癌根治术安全、可行,具有良好的临床应用前景。Objective： To study the operative techniques and clinical feasibility of preservation of left colon artery and superior rectal artery for the laparoscopic resection of sigmoid colon carcinoma,and to compare it with the traditional surgical method. Methods：From Jan. 2015 to Nov. 2016,clinical data of 82 patients with sigmoid colon carcinoma were retrospectively analyzed. These patients were divided into retained vascular group and traditional surgical group. Twenty-four patients were enrolled in the retained vascular group,while 58 patients were enrolled in the traditional surgical group. The retained vascular group kept left colon artery and superior rectal artery,while the traditional surgical group received conventional surgery. The operation time,number of resected lymph nodes,blood loss and anastomotic healing status were compared between the two groups. Results： The mean operation time was（ 279. 43 ±47. 21） min,the mean harvested lymph node was（ 15. 2 ± 5. 4） and the mean blood loss was（ 53. 32 ± 15. 68） ml in the retained vascular group. The number of resected lymph nodes and blood loss were not statistically significantly different between these two groups（ P〉0. 05）. Longer operating time was observed in the retained vascular group as compared to the traditional surgical group（ P〈0. 05）.There was no anastomotic fistula in the retained vascular group,however,two anastomotic fistula occurred in the traditional surgical group,there was no statistically significant difference between the two groups（ P〉0. 05）. Conclusions： Preservation of left colon artery and superior rectal artery is safe and feasible for the laparoscopic treatment of sigmoid colon carcinoma and has good clinical application prospect.

关 键 词：乙状结肠肿瘤 乙状结肠癌根治术 腹腔镜检查 左结肠动脉 直肠上动脉 

分 类 号：R735.35[医药卫生—肿瘤]