腹腔镜直肠癌根治术保留左结肠动脉的安全性及近期疗效评价  

Evaluation on the safety and short-term efficacy of laparoscopic radical resection of rectal cancer with preservation of the left colonic artery

作　　者：周仕海[1] 陈宏[1] 雒洪志[1] ZHOU Shihai;CHEN Hong;LUO Hongzhi(Department of Oncology,Zhongshan City People’s Hospital,Guangdong,Zhongshan 528403,China)

机构地区：[1]广东省中山市人民医院肿瘤外科,广东中山528403

出　　处：《中国医药科学》2022年第10期144-148,共5页China Medicine And Pharmacy

基　　金：广东省中山市第一批社会公益与基础研究项目(2020B1082)。

摘　　要：目的探讨腹腔镜直肠癌根治术保留左结肠动脉的安全性及近期疗效。方法回顾性分析2017年8月至2020年8月在中山市人民医院行腹腔镜直肠癌根治术的182例患者的临床资料,根据手术方法不同分为观察组[保留左结肠动脉(LCA)组]75例,对照组(不保留LCA组)107例。比较两组患者手术时间、术中出血量、淋巴结清扫数目、术后并发症发生情况、术后排气时间、术后进食流质时间、术后住院天数等指标。结果观察组手术时间长于对照组,差异有统计学意义(P<0.05)。观察组与对照组术中出血量、淋巴结清扫数目、肿瘤TNM分期差异均无统计学意义(P>0.05)。观察组术后排气时间、术后下地活动时间较对照组早,术后住院天数较对照组短,差异有统计学意义(P<0.05)。两组并发症总发生率差异无统计学意义(P>0.05)。结论腹腔镜直肠癌根治术保留左结肠动脉的安全性及近期疗效好,促进患者的快速康复,值得推广。Objective To investigate the safety and short-term efficacy of laparoscopic radical resection of rectal cancer with preservation of the left colonic artery(LCA).Methods The clinical data of 182 patients who underwent laparoscopic radical resection of rectal cancer at Zhongshan City People’s Hospital from August 2017 to August 2020 were retrospectively analyzed,and these patients were divided into the observation group(n=75,with LCA preservation)and the control group(n=107,with no LCA preservation)according to the surgical method.The operating time,intraoperative bleeding volume,number of lymph-node dissected,occurrence of postoperative complications,postoperative exhaust time,time of eating fluids,and number of postoperative hospital days were compared between the two groups.Results The operating time of the observation group was longer than that of the control group,with statistically significant differences(P<0.05).There were no statistically significant differences between the observation group and the control group in intraoperative bleeding volume,number of lymph-node dissected,and TNM stage of tumor(P>0.05).The observation group had earlier postoperative exhaust time and ambulation time,and shorter postoperative hospitalization days than the control group,with statistically significant differences(P<0.05).There was no statistically significant difference between the two groups in the total incidence of complications(P>0.05).Conclusion It is concluded that laparoscopic radical resection of rectal cancer with preservation of LCA promotes the rapid recovery of patients and shows high safety and good short-term efficacy,and therefore it is worthy of promotion.

关 键 词：腹腔镜 直肠癌 左结肠动脉 肠系膜下动脉 并发症 

分 类 号：R735.37[医药卫生—肿瘤]