腹腔镜直肠低位前切除术中保留左结肠动脉的短期效果评价  

Short-term efficacy evaluation of preserving left colic artery in laparoscopic low anterior resection of rectal cancer

作　　者：张伟[1] 毛佳佳[2] 王晓阳[2] 刘志[2] 金明新[2] 武群政 ZHANG Wei;MAO Jia-jia;WANG Xiao-yang(Department of Gastrointestinal Surgery,Pingyin People’s Hospital,Jinan 250400,China;Department of General Surgery,Qilu Hospital of Shandong University)

机构地区：[1]平阴县人民医院胃肠外科,山东济南250400 [2]山东大学齐鲁医院普通外科

出　　处：《腹腔镜外科杂志》2021年第6期415-418,共4页Journal of Laparoscopic Surgery

摘　　要：目的:评估腹腔镜直肠低位前切除术中保留左结肠动脉的短期效果。方法:回顾分析2019年1月至2020年8月收治的316例行腹腔镜直肠低位前切除术患者的临床资料,根据是否保留左结肠动脉分为观察组(保留左结肠动脉,n=177)与对照组(不保留左结肠动脉,n=139),对比分析两组手术时间、术中出血量、淋巴结清扫数量、术后并发症、术后首次排气时间、住院时间等。结果:两组术中出血量、淋巴结清扫数量、术后并发症、术后首次排气时间、住院时间差异无统计学意义,观察组手术时间长于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜直肠低位前切除术中保留左结肠动脉在术中出血、淋巴结清扫、术后并发症、术后首次排气时间及住院时间方面并无显著优势,但增加了手术难度,同时延长了手术时间,因此腹腔镜直肠低位前切除术中不必刻意保留左结肠动脉。Objective:To evaluate the short-term efficacy of preserving left colic artery in laparoscopic low anterior resection of rectal cancer.Methods:Retrospective analysis was performed on the clinical data of 316 patients who underwent laparoscopic low anterior resection of rectal cancer from Jan.2019 to Aug.2020.According to the left colonic artery was preserved or not,they were divided into observation group(preserving the left colonic artery,n=177)and control group(without preservation of the left colonic artery,n=139).The operative time,bleeding volume,lymph node dissected,postoperative complications,the time of exsufflation and hospitalization after operation were compared between two groups.Results:There were no significant difference in bleeding volume,lymph node dissected,postoperative complications,the time of exsufflation and hospitalization after operation between the two groups.The operation time of the observation group was significantly longer than that of the control group(P<0.05).Conclusions:Preserving the left colonic artery during laparoscopic low anterior resection of rectal cancer has no significant advantages in terms of bleeding volume,lymph node dissection,postoperative complications,the time of exsufflation and hospitalization after operation.On the contrary,as the adverse effect of preserving the left colonic artery,the operation difficulty increases and the operation time prolongs.Therefore,it is not intentionally necessary to preserve the left colonic artery in laparoscopic low anterior resection of rectal cancer.

关 键 词：直肠肿瘤 低位前切除术 腹腔镜检查 左结肠动脉 

分 类 号：R735.3+7[医药卫生—肿瘤]