保留左半结肠血管的TME手术对术后便秘的影响  

Reserve the left half colon vascular in TME surgery affect postoperative constipation

作　　者：庄依泽 杨梦楠 麻蛟蛟 王田 樊世坤 许佳文 郑春华 ZHUANG Yize;YANG Mengnan;MA Jiaojiao;WANG Tian;FAN Shikun;XU Jiawen;ZHENG Chunhua(Guiyang Guihang 300 Hospital Affiliated to Zunyi Medical University,Guizhou Guiyang 550009,China;Affiliated Hospital of Guizhou Medical University,Guizhou Guiyang 550004,China)

机构地区：[1]遵义医科大学附属贵航300医院,贵州贵阳550009 [2]贵州医科大学附属医院,贵州贵阳550004

出　　处：《现代肿瘤医学》2022年第3期492-495,共4页Journal of Modern Oncology

摘　　要：目的:通过对接受腹腔镜直肠癌根治(total mesorectal excision,TME)手术患者的术后随访,探究保留左半结肠血管对术后便秘及相关并发症的影响。方法:我院普外科2015年05月至2017年05月共收治的93例直肠肠癌根治手术患者进行回顾性分析。结果:对于病人的年龄、性别、BMI、术前CEA、术中出血量、吻合口瘘、术后肿瘤复发率,是否保留左半结肠血管方面无差异(P>0.05)。低位结扎组在术后肠道功能恢复、吻合口炎症以及术后便秘发生率中明显优于高位结扎组(P<0.05);高位结扎组在手术时间上优于低位结扎组(P<0.05)。结论:保留左半结肠的TME手术可以完成同样的淋巴结清扫,虽然术中用时较长但一定程度上保护了肠道的血运及神经,降低了术后便秘的发生率,值得临床进一步研究与推广。Objective:To through the postoperative follow-up of patients who underwent laparoscopic radical resection of rectal cance(TME)to investigate the effect of ligation of left colonic blood vessels on postoperative constipation.Methods:A retrospective analysis was performed on 93 patients admitted to TME in hospital from May 2015 to May 2017.Results:There were no significant differences in patients'age,gender,operation time,intraoperative blood loss,BMI,preoperative CEA,incidence of anastomosis and postoperative tumor recurrence rate(P>0.05).The low ligation group was significantly better than the high ligation group in postoperative recovery of intestinal function,anastomic inflammation and incidence of postoperative constipation(P<0.05).The high ligation group was superior to the low ligation group in operation time(P<0.05).Conclusion:TME surgery with the left colon preserved can complete the same lymph node dissection,protect the intestinal blood circulation to a certain extent,and reduce the incidence of postoperative constipation,which is worthy of further clinical research and promotion.

关 键 词：左半结肠动脉 腹腔镜直肠癌根治术 低位结扎 术后便秘 

分 类 号：R735.3[医药卫生—肿瘤]