老年患者腹腔镜直肠癌根治术行肠系膜下动脉高位结扎与低位结扎的临床疗效比较  

Comparison of clinical effect between high ligation and low ligation of inferior mesenteric artery in elderly patients with laparoscopic radical resection of rectal cancer

作　　者：王长庭[1] 苏志明[1] 曾伟龙 Wang Changting;Su Zhiming;Zeng Weilong(Department of General Surgery,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院普外科,泉州362000

出　　处：《中华实验外科杂志》2022年第6期1157-1160,共4页Chinese Journal of Experimental Surgery

基　　金：泉州市科技计划项目基金资助(2021N012S)。

摘　　要：目的比较老年患者腹腔镜直肠癌根治术行肠系膜下动脉高位结扎与低位结扎的临床疗效。方法收集福建医科大学附属第二医院2015年1月至2020年1月130例60岁以上行腹腔镜直肠癌根治术的老年患者的临床资料, 根据肠系膜下动脉结扎的位置分为高位结扎组和低位结扎组, 其中高位结扎组65例, 低位结扎组65例, 比较分析两组患者术前临床资料、围手术期相关指标及淋巴结清扫情况。结果低位结扎组的手术时间长于高位结扎组[(197.54±13.35) min比(171.08±13.48) min, t=-8.615, P<0.05];低位结扎组的术后肛门排气时间短于高位结扎组[(51.32±7.79) h比(66.83±7.93) h, t=3.156, P<0.05];低位结扎组的术后住院时间短于高位结扎组[(8.12±1.78) d比(9.92±2.49) d, t=4.725, P<0.05];低位结扎组的吻合口漏发生率低于高位结扎组[3.07%(2/65)比9.23%(6/65), χ^(2)=6.385, P<0.05]。结论老年患者腹腔镜直肠癌根治术行肠系膜下动脉低位结扎在根治性清扫的基础上减少了吻合口漏的发生率, 同时具有术后恢复快、减少住院时间的优势。Objective To compare the clinical effect of high ligation and low ligation of inferior mesenteric artery in elderly patients with laparoscopic radical resection of rectal cancer.Methods The clinical data of 130 elderly patients over 60 years old who underwent laparoscopic radical rectal cancer surgery in the Second Affiliated Hospital of Fujian Medical University from January 2015 to January 2020 were collected.According to the location of ligation of inferior mesenteric artery,they were divided into high ligation group(n=65)and low ligation group(n=65).Preoperative clinical data,perioperative related indicators and lymph node dissection of patients in the two groups were compared and analyzed.SPSS19.0 software was used for statistical analysis,and P<0.05 was considered as statistically significant.Results The operation time of low ligation group was longer than that of high ligation group[(197.54±13.35)min vs.(171.08±13.48)min,t=-8.615,P<0.05].The postoperative anal exhaust time and postoperative hospital stay in low ligation group were shorter than those in high ligation group[(51.32±7.79)h vs.(66.83±7.93)h,t=3.156,P<0.05].The postoperative hospital stay in low ligation group was shorter than that in high ligation group[(8.12±1.78)d vs.(9.92±2.49)d,t=4.725,P<0.05].The incidence of anastomotic leakage in low ligation group was lower than that in high ligation group[3.07%(2/65)vs.9.23%(6/65),χ^(2)=6.385,P<0.05].There were no significant differences in intraoperative blood loss,and total number of dissected lymph nodes between the two groups.Conclusion Laparoscopic ligation of inferior mesenteric artery in elderly patients with rectal cancer can reduce the incidence of anastomotic leakage on the basis of radical resection,and has the advantages of fast postoperative recovery and shortened hospital stay.

关 键 词：腹腔镜直肠癌根治术 肠系膜下动脉 高位结扎 低位结扎 

分 类 号：R735.37[医药卫生—肿瘤]