腹腔镜直肠癌前切除术中保留左结肠动脉的可行性与应用价值  

Feasibility and application value of preserving left colon artery in laparoscopic anterior resection of rectal cancer

作　　者：李志旺[1] 吴祖光[1] 李恩[1] 刘宏涛[1] 张灼新[1] LI Zhi-wang;WU Zu-guang;LI En;LIU Hong-tao;ZHANG Zhuo-xin(Department of First Gastrointestinal Surgery,Meizhou people's Hospital in Guangdong Province,Meizhou 514031,China)

机构地区：[1]广东省梅州市人民医院胃肠外一科,广东梅州514031

出　　处：《中国当代医药》2019年第8期68-70,共3页China Modern Medicine

基　　金：广东省梅州市医药卫生科研立项课题(2018-B-3)

摘　　要：目的探讨腹腔镜直肠癌前切除术中保留左结肠动脉(left colic artery,LCA)的可行性与应用价值。方法选取我院2016年12月～2018年6月行腹腔镜直肠癌前切除术的167例直肠癌患者作为研究对象,随机分为研究组(83例)和对照组(84例)。研究组术中保留LCA,对照组术中不保留LCA。比较两组患者的术中出血量、术后排气时间、术后发生吻合口瘘的情况、淋巴结清扫数目、手术时间、游离脾曲、回肠造口发生情况。结果两组患者的手术时间、术中出血量、淋巴结清扫数目、术后排气时间及回肠造口发生率比较,差异无统计学意义(P>0.05);研究组患者的吻合口瘘发生率低于对照组,差异有统计学意义(P<0.05);研究组患者的游离脾曲发生率低于对照组,差异有统计学意义(P<0.05)。结论保留LCA的腹腔镜直肠癌前切除术能降低吻合口瘘的发生率,保证吻合口的正常血运。Objective To explore the feasibility and application value of preserving left colon artery (LCA) in laparoscopic anterior resection of rectal cancer. Methods A total of 167 patients with rectal cancer who underwent laparoscopic anterior resection of rectal cancer in our hospital from December 2016 to June 2018 were randomly divided into study group (83 cases) and control group (84 cases). The LCA was preserved in the study group,while the LCA was not preserved in the control group. The amount of bleeding during operation,the time of exhaust after operation,the occurrence of anastomotic leakage after operation,the number of lymph node dissection,the time of operation,the occurrence of free splenic curvature and ileostomy were compared between the two groups. Results There were no significant differences in operation time,intraoperative blood loss,number of lymph node dissection,exhaust time and incidence of ileostomy between the two groups (P>0.05). The incidence of anastomotic leakage in the study group was lower than that in the control group,the difference was significant (P<0.05). The incidence of free splenic flexure in the study group was lower than that in the control group,the difference was significant (P<0.05). Conclusion Laparoscopic anterior resection of rectal cancer with LCA preservation can reduce the incidence of anastomotic leakage and ensure the normal blood supply of anastomotic stoma.

关 键 词：直肠癌 直肠癌前切除术 左结肠动脉 肠系膜下动脉 吻合口瘘 

分 类 号：R574.63[医药卫生—消化系统]