保留左结肠动脉对腹腔镜下中低位直肠癌根治术疗效的影响

Influence of preserving left colon artery on therapeutic effect of laparoscopic radical resection of middle and low rectal cancer

  • 摘要:
      目的  评估腹腔镜下中低位直肠癌根治术中保留左结肠动脉对术后吻合口漏及近期疗效的影响。
      方法  选取行腹腔镜下中低位直肠癌根治术的90例患者为研究对象,观察组45例保留左结肠动脉,对照组45例不保留左结肠动脉,比较2组术中及术后临床指标。
      结果  2组均顺利完成腹腔镜手术。2组手术时间、术中出血量、吻合口漏发生率、淋巴结清扫数量、术后住院时间、术后肛门排气时间、自主排尿时间比较,差异均无统计学意义(P>0.05); 2组患者游离脾曲率、末端回肠造口率、术后低位前切除综合征发生率比较,差异均有统计学意义(P < 0.05)。
      结论  保留左结肠动脉有效保障了吻合口近端肠管的血流供给,减轻了上腹下丛神经的损伤,降低了术后并发症发生率。

     

    Abstract:
      Objective  To evaluate the influence of preserving left colonic artery on postoperative anastomotic leakage and short-term effect in patients with laparoscopic radical resection of middle and low rectal cancer.
      Methods  A total of 90 patients with laparoscopic radical resection of middle and low rectal cancer were selected as research objects. A total of 45 patients in the observation group chose to preserve left colonic artery, while 45 patients in control group decided not to preserve the left colonic artery, and the intraoperative and postoperative clinical indexes were compared between the two groups.
      Results  Patients in both groups successfully completed laparoscopic surgery. There were no significant differences in operation time, intraoperative blood loss, incidence rate of anastomotic leakage, number of lymph node dissection, postoperative hospital stay, postoperative anal exhaust time and spontaneous urination time between the two groups (P>0.05). There were significant differences in free spleen curvature, terminal ileostomy rate and postoperative incidence of low anterior resection syndrome between the two groups (P < 0.05).
      Conclusion  Preserving the left colonic artery can effectively ensure the blood supply of the intestinal canal at the proximal end of the anastomosis, alleviate the injury of inferior plexus of upper abdomen, and reduce the incidence of postoperative complications.

     

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