保留左结肠动脉对腹腔镜下中低位直肠癌根治术疗效的影响  

Influence of preserving left colon artery on therapeutic effect of laparoscopic radical resection of middle and low rectal cancer

作　　者：黄永 陈小军[2] 杨永国[3] 马晔 伏广顺 韦伟[1] HUANG Yong;CHEN Xiaojun;YANG Yongguo;MA Ye;FU Guangshun;WEI Wei(Department of General Surgery,Jiangdu People′s Hospital of Yangzhou City in Jiangsu Province,Yangzhou,Jiangsu,225100;Department of Oncology,Jiangdu People′s Hospital of Yangzhou City in Jiangsu Province,Yangzhou,Jiangsu,225100;Department of Pathology,Jiangdu People′s Hospital of Yangzhou City in Jiangsu Province,Yangzhou,Jiangsu,225100;Department of Radiology,Jiangdu People′s Hospital of Yangzhou City in Jiangsu Province,Yangzhou,Jiangsu,225100)

机构地区：[1]江苏省扬州市江都人民医院普外科,江苏扬州225100 [2]江苏省扬州市江都人民医院肿瘤科,江苏扬州225100 [3]江苏省扬州市江都人民医院病理科,江苏扬州225100 [4]江苏省扬州市江都人民医院放射科,江苏扬州225100

出　　处：《实用临床医药杂志》2022年第8期91-94,共4页Journal of Clinical Medicine in Practice

基　　金：江苏省扬州市江都人民医院科研基金项目(YNKT201906)。

摘　　要：目的评估腹腔镜下中低位直肠癌根治术中保留左结肠动脉对术后吻合口漏及近期疗效的影响。方法选取行腹腔镜下中低位直肠癌根治术的90例患者为研究对象,观察组45例保留左结肠动脉,对照组45例不保留左结肠动脉,比较2组术中及术后临床指标。结果2组均顺利完成腹腔镜手术。2组手术时间、术中出血量、吻合口漏发生率、淋巴结清扫数量、术后住院时间、术后肛门排气时间、自主排尿时间比较,差异均无统计学意义(P>0.05);2组患者游离脾曲率、末端回肠造口率、术后低位前切除综合征发生率比较,差异均有统计学意义(P<0.05)。结论保留左结肠动脉有效保障了吻合口近端肠管的血流供给,减轻了上腹下丛神经的损伤,降低了术后并发症发生率。Objective To evaluate the influence of preserving left colonic artery on postoperative anastomotic leakage and short-term effect in patients with laparoscopic radical resection of middle and low rectal cancer.Methods A total of 90 patients with laparoscopic radical resection of middle and low rectal cancer were selected as research objects.A total of 45 patients in the observation group chose to preserve left colonic artery,while 45 patients in control group decided not to preserve the left colonic artery,and the intraoperative and postoperative clinical indexes were compared between the two groups.Results Patients in both groups successfully completed laparoscopic surgery.There were no significant differences in operation time,intraoperative blood loss,incidence rate of anastomotic leakage,number of lymph node dissection,postoperative hospital stay,postoperative anal exhaust time and spontaneous urination time between the two groups(P>0.05).There were significant differences in free spleen curvature,terminal ileostomy rate and postoperative incidence of low anterior resection syndrome between the two groups(P<0.05).Conclusion Preserving the left colonic artery can effectively ensure the blood supply of the intestinal canal at the proximal end of the anastomosis,alleviate the injury of inferior plexus of upper abdomen,and reduce the incidence of postoperative complications.

关 键 词：直肠肿瘤 腹腔镜 左结肠动脉 吻合口漏 末端回肠造口 

分 类 号：R735.3[医药卫生—肿瘤] R615[医药卫生—临床医学]