保留左结肠动脉的腹腔镜全直肠系膜切除术治疗直肠癌的疗效分析  

Curative effect of laparoscopic total mesorectal excision with preservation of the left colon artery on rectal cancer

作　　者：梁奇正[1] Liang Qizheng(Department of Gastrointestinal Surgery,Fendong District of Taiyuan Central Hospital,Taiyuan 030032,China)

机构地区：[1]山西省太原市中心医院汾东院区胃肠外科,太原030032

出　　处：《中国实用医刊》2022年第7期37-39,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨保留左结肠动脉的腹腔镜全直肠系膜切除术治疗直肠癌的疗效。方法抽取2018年1月至2020年6月太原市中心医院汾东院区收治的直肠癌患者96例,按随机数字表法分为观察组与对照组,每组48例。对照组采用常规腹腔镜全直肠系膜切除术且不保留左结肠动脉,观察组采用保留左结肠动脉的腹腔镜全直肠系膜切除术。比较两组手术指标、恢复情况、并发症、随访2年复发率与转移率。结果两组手术时间、术中出血量比较差异未见统计学意义(P>0.05),但观察组术后肠道开放时间、首次排便时间、术后住院时间均短于对照组(P均<0.05);观察组术后并发症发生率(8.33%,4/48)低于对照组(29.17%,14/48),P<0.05,但随访复发率与转移率比较差异未见统计学意义(P>0.05)。结论相较于不保留左结肠动脉,腹腔镜全直肠系膜切除术期间保留左结肠动脉,可缩短术后恢复时间,并发症较少。Objective To investigate the curative effect of laparoscopic total mesorectal excision with preservation of the left colon artery(LCA)for rectal cancer.Methods A total of 96 rectal cancer patients admitted to Fendong District of Taiyuan Central Hospital from January 2018 to June 2020 were selected for the study.And they were divided into observation group and control group by random number table method,with 48 cases in each group.The control group underwent conventional laparoscopic total mesorectal excision without preserving the LCA,while the observation group underwent laparoscopic total mesorectal excision with preservation of LCA.The surgical indicators,postoperative recovery indicators,complications,2-year follow-up recurrence rate and metastasis rate were compared between the two groups.Results There was no significant difference in operation time and bleeding volume between the two groups(P>0.05),but the postoperative intestinal opening time,first defecation time and postoperative hospital stay in the observation group were shorter than those in the control group(all P<0.05).The incidence of postoperative complications in the observation group(8.33%,4/48)was lower than that in the control group(29.17%,14/48),P<0.05.But there was no significant difference in the recurrence rate and metastasis rate between the two groups(P>0.05).Conclusions Compared with the operation without preserving the LCA,preservation of LCA during laparoscopic total mesorectal excision for rectal cancer can shorten the postoperative recovery time,have fewer complications.

关 键 词：直肠癌 腹腔镜全直肠系膜切除术 左结肠动脉 保留 并发症 

分 类 号：R735.37[医药卫生—肿瘤]