腹腔镜下保留左结肠动脉的中低位直肠癌根治术的疗效分析  

Analysis of the efficacy of laparoscopic radical surgery for middle and low rectal cancer with preservation of the left colonic artery

作　　者：池振宇 赵芳[2] CHI Zhenyu;ZHAO Fang(Zhejiang Chinese Medical University,ZheJiang 310053,China;Anji County People's Hospital,ZheJiang 313300,China)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江省安吉县人民医院

出　　处：《浙江创伤外科》2025年第1期9-11,15,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的 探讨腹腔镜下保留左结肠动脉的中低位直肠癌根治术的临床疗效。方法 回顾性分析2020年12月至2023年12月本院收治的72例中低位直肠癌患者的临床资料,按照其在术中是否保留其左结肠动脉将其分为观察组和对照组各36例。观察比较两组患者的手术指标、术后恢复情况、清扫淋巴结的情况和并发症的发生情况。结果 两组患者的手术时间、术中出血量和肠管远端切缘长度差异无统计学意义(P>0.05);而观察组的脾曲游离率显著低于对照组,差异具备统计学意义(P<0.05)。对照组患者的肛门排气时间、术后膀胱残尿量和术后肠鸣音恢复时间均显著高于观察组,差异具备统计学意义(P<0.05)。两组患者的总淋巴结清扫数和No.253组淋巴结清扫数比较差异无统计学意义(P>0.05)。观察组患者术后的并发症的发生率显著低于对照组,差异具备统计学意义(P<0.05)。结论 通过中低位直肠癌根治术中保留左结肠动脉可以加速患者术后恢复,减少并发症的发生率,值得临床实践中使用。Objective To explore the clinical efficacy of laparoscopic radical surgery for middle and low rectal cancer with preservation of the left colonic artery.Methods A retrospective analysis was conducted on the clinical data of 72 patients with middle and low rectal cancer treated in our hospital from December 2020 to December 2023.These patients were divided into an observation group and a control group(36 cases each)based on whether the left colonic artery was preserved during surgery.Postoperative recovery,lymph node dissection,and complication rates were compared between the two groups.Results There were no statistically significant differences in operative time,intraoperative blood loss,or distal intestinal resection margin length between the two groups(P>0.05).However,the splenic flexure mobilization rate in the observation group was significantly lower than that in the control group(P<0.05).The control group had significantly longer anal exhaust time,higher postoperative residual bladder volume,and longer postoperative bowel sound recovery time compared to the observation group(P<0.05).There was no significant difference in the total number of lymph nodes dissected or the number of No.253 lymph nodes dissected between the two groups(P>0.05).The incidence of postoperative complications was significantly lower in the observation group than that in the control group(P<0.05).Conclusion Preservation of the left colonic artery during laparoscopic radical surgery for middle and low rectal cancer can accelerate postoperative recovery and reduce the incidence of complications,making it a viable option for clinical practice.

关 键 词：腹腔镜 左结肠动脉 中低位直肠癌 直肠癌根治术 疗效 

分 类 号：R735.3[医药卫生—肿瘤]