腹腔镜下高位与低位结扎肠系膜下动脉对低位直肠癌患者的影响  

Effect of laparoscopic high and low ligation of inferior mesenteric artery on patients with low rectal cancer

作　　者：兰运升 赵梓竣 Lan Yunsheng;Zhao Zijun(Department of Gastrointestinal Surgery,Suining Central Hospital,Suining Sichuan Province 629000,China)

机构地区：[1]遂宁市中心医院胃肠外科,四川遂宁629000

出　　处：《中华普外科手术学杂志（电子版）》2024年第5期551-553,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的:探究腹腔镜下肠系膜下动脉(IMA)不同结扎位点对低位直肠癌患者围手术期与并发症的影响。方法:回顾性分析2021年8月至2023年8月142例低位直肠癌患者病例资料,依据手术方法不同,将采用腹腔镜下高位结扎的72例患者分为高位组,采用腹腔镜下低位结扎的70例患者分为低位组。采用SPSS 22.0统计软件分析数据,围手术期指标以(x±s)表示,行独立样本t检验;并发症、复发、死亡情况行χ^(2)检验。P<0.05为差异有统计学意义。结果:高位组患者术后排气时间高于低位组,术后1个月尿失禁发生率(2.8%vs.11.4%)低于低位组,术后3~6个月低位前切除综合征发生率(51.4%vs.34.3%)高于低位组,差异有统计学意义(P<0.05);其余围手术期指标、并发症及复发、转移和死亡率与低位组患者比较差异无统计学意义(P>0.05)。结论:腹腔镜下低位结扎肠可促进低位直肠癌患者术后肠功能恢复,短期并发症发生率较低,而高位结扎对自主神经丛损伤较小,术后尿失禁发生较低。Objective:To explore the effect of different ligation sites of inferior mesenteric artery(IMA)on perioperative period and complications in patients with low rectal cancer.Methods:Data of 142 patients with low rectal cancer from August 2021 to August 2023 were retrospectively analyzed.According to different surgical methods,72 patients with laparoscopic high ligation were divided into high group and 70 patients with laparoscopic low ligation were divided into low group.SPSS 22.0 statistical software was used to analyze the data.Perioperative indicators were expressed as(x±s),and independent sample t test was performed.The complications,recurrence and death were examined byχ^(2) test.P<0.05 was considered to be statistically significant.Results:The postoperative exhaust time in the high group was higher than that in the low group,the incidence of urinary incontinence one month after surgery(2.8%vs.11.4%)was lower than that in the low group,and the incidence of low anterior resection syndrome(51.4%vs.34.3%)was higher than that in the low group 3-6 months after surgery,with statistical significance(P<0.05).Other perioperative indexes,complications,recurrence,metastasis and mortality were not significantly different from those in the lower group(P>0.05).Conclusion:Laparoscopic low ligation of intestine can promote postoperative intestinal function recovery in patients with low rectal cancer,with a lower incidence of short-term complications,while high ligation has less damage to autonomic nerve plexus and a lower incidence of postoperative urinary incontinence.

关 键 词：直肠肿瘤 腹腔镜 肠系膜下动脉 结扎术 

分 类 号：R735.37[医药卫生—肿瘤]