保留左结肠动脉与否对腹腔镜直肠癌切除术疗效的影响研究  

Effect of left colic artery preservation or not on perioperative complications and long-term outcomes of laparoscopic resection of rectal cancer

作　　者：魏君[1] 邱磊[1] 谢沛标[1] 张少锐[1] 钟育波[1] Wei Jun;Qiu Lei;Xie Peibiao;Zhang Shaorui;Zhong Yubo.(Department of Gastrointestinal Surgery, The Second People＇s Hospital of Foshan, Foshan, Guangdong, 528000, Chin)

机构地区：[1]佛山市第二人民医院胃肠外科,广东佛山528000

出　　处：《结直肠肛门外科》2018年第2期130-133,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨保留左结肠动脉(LCA)与否对腹腔镜直肠癌切除术疗效的影响。方法回顾性分析本院94例行腹腔镜直肠癌切除术患者的临床资料,分为保留LCA(观察组)与未保留LCA(对照组),每组各47例。对比两组手术相关指标(手术时间、术后出血量、住院时间、排气时间、下床活动时间、淋巴结清扫数目、肿瘤距切缘距离、肿瘤直径),分析围手术期并发症发生率,术中乙状结肠造瘘率和游离脾曲率,并比较术后5年生存率。结果两组手术时间、术中出血量、排气时间、下床活动时间、住院时间、淋巴结清扫数目、肿瘤距切缘距离、肿瘤直径差异均无统计学意义(均P>0.05)。两组术后切口感染、腹腔感染、肠梗阻发生率差异均无统计学意义(均P>0.05)。观察组术后吻合口漏发生率及乙状结肠造瘘率、游离脾曲率均显著低于对照组,差异均有统计学意义(均P<0.05)。两组5年生存率差异无统计学意义(P>0.05)。结论腹腔镜直肠癌切除术中保留LCA与否近期疗效及远期生存率相当,保留LCA可减少吻合口漏的发生及降低术中乙状结肠造瘘率、游离结肠脾曲率,对患者更有益。Objective To investigate the effect of left colic artery（LCA） preservation on laparoscopic resection of rectal cancer.Methods The clinical data of 94 patients with laparoscopic resection of rectal cancer in our hospital were retrospectively analyzed.Patients were divided into preserved LCA group（treatment group） and no preservation group（control group）, with 47 patients in each group. Operation duration, bleeding volume, hospitalization duration, postoperative exhaust time, ambulation time, number of lymph node dissected, tumor-to-incision margin, tumor diameter were compared between the two groups. Incidence of perioperative complications, sigmoid colostomy and separated spleen flexure. The 5-year survival rate was compared. Results There was no significant difference between the two groups in terms of operation duration, blood loss, exhaust time, ambulation time, hospitalization duration,number of lymph node dissected, tumor-to-incision margin, and tumor diameter（P 〉 0.05）. There was no significant difference in incision infection, abdominal infection and intestinal obstruction between the two groups（P 〉 0.05）. The incidence of anastomotic leakage, sigmoid colostomy and separated spleen flexure were significantly lower in the treatment group than in the control group（P 〈0.05）. There is no significant difference in the 5-year survival rate between the two groups（P 〉 0.05）. Conclusion In laparoscopic resection of rectal cancer, the short-term and long-term survival rate of with and without LCA preservation are similar, but the former is more likely to reduce the incidence of anastomotic leakage, sigmoid colostomy, or separated spleen flexure.

关 键 词：左结肠动脉 腹腔镜直肠癌 疗效 近期并发症 

分 类 号：R735.3[医药卫生—肿瘤]