腹腔镜乙状结肠癌根治术中保留左结肠动脉及直肠上动脉对老年患者的效果分析  

Effect of left colonic artery and superior rectal artery preservation in laparoscopic radical resection of sigmoid cancer in elderly patients

作　　者：朱秋伟 华卫俊 傅跃 石骏 朱平 华逸 ZHU Qiuwei;HUA Weijun;FU Yue;SHI Jun;ZHU Ping;HUA Yi(Department of Gastrointestinal Surgery,Changzhou Second People′s Hospital Affiliated to Nanjing Medical University,Changzhou,Jiangsu,213000)

机构地区：[1]南京医科大学附属常州第二人民医院胃肠外科,江苏常州213000

出　　处：《实用临床医药杂志》2023年第5期82-84,91,共4页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金资助项目(81902391)。

摘　　要：目的 观察腹腔镜乙状结肠癌根治术中保留左结肠动脉(LCA)及直肠上动脉(SRA)对老年乙状结肠癌患者的效果。方法 收集320例接受腹腔镜乙状结肠癌根治术的老年患者病例资料,将129例保留LCA及SRA者纳入实验组,191例未保留LCA及SRA者纳入对照组,比较2组患者术中及术后相关情况。结果 实验组均未行预防性回肠造瘘,对照组有9例行预防性回肠造瘘,差异有统计学意义(P<0.05);实验组手术时间长于对照组,差异有统计学意义(P<0.05);2组在淋巴结清扫总数与第253组淋巴结清扫数量、术中出血量以及术后吻合口出血、吻合口漏发生率、肠鸣音恢复时间、术后排气时间、住院时间方面比较,差异均无统计学意义(P>0.05)。结论 老年乙状结肠癌患者行腹腔镜乙状结肠癌根治术中保留LCA及SRA,可减少预防性回肠造瘘,且在技术上安全可行。Objective To observe the clinical effect of preservation of the left colonic artery(LCA)and superior rectal artery(SRA)in laparoscopic radical resection of sigmoid cancer in elderly patients.Methods The clinical data of 320 patients with sigmoid colon carcinoma undergoing laparoscopic radical resection were retrospectively analyzed.A total of 129 patients who retained LCA and SRA were included in experimental group,and 191 patients who did not retain LCA and SRA were included in control group.The intraoperative and postoperative conditions of the two groups were compared.Results The experimental group underwent no prophylactic ileostomy,and 9 cases in the control group received prophylactic ileostomy,a significant difference was found in two groups(P<0.05).Operation time was significantly longer in the experimental group than that in the control group(P<0.05).No significant differences in terms of total number of lymph node dissection and the number of lymph node(No.253)dissection,intraoperative blood loss,postoperative anastomotic bleeding,incidence of anastomotic leakage,recovery time of bowel sound,postoperative exhaust time and length of hospital stay were found between the two groups(P>0.05).Conclusion Preservation of LCA and SRA in laparoscopic radical resection of sigmoid cancer in elderly patients can reduce preventive terminal ileum stoma and it is safe and feasible in technology.

关 键 词：乙状结肠癌 老年患者 左结肠动脉 直肠上动脉 腹腔镜 吻合口漏 预防性回肠造瘘 

分 类 号：R735.3[医药卫生—肿瘤] R615[医药卫生—临床医学]