Significance and clinical application of preserving left colonartery in laparoscopic radical resection of rectal cancer
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摘要:目的 分析腹腔镜直肠癌根治术中保留左结肠动脉的意义及其临床应用。方法 选取本院2017年1月—2019年1月接诊的100例采取腹腔镜直肠癌根治术的患者为研究对象，根据术中是否保留左结肠动脉将患者均分为对照组和观察组，各50例。对照组选择术中不保留左结肠动脉，观察组则术中保留左结肠动脉。分析2组患者术中出血量、手术时间、通气时间、住院时间、淋巴结清扫数目、术后病理学结果以及恢复情况。结果 2组患者的术中出血量、手术时间、住院时间、淋巴结清扫数目差异无统计学意义(P>0.05); 观察组术后通气时间(2.56±0.41)d显著短于对照组的(2.81±0.53) d(P < 0.05)。2组患者组织学类型、TNM分期、术后尿潴留、性功能障碍发生率差异无统计学意义(P>0.05); 观察组吻合口瘘的发生率显著低于对照组(P < 0.05)。结论 腹腔镜直肠癌根治术中保留左结肠动脉对患者术中出血量、手术时间、通气时间、住院时间、淋巴结清扫数目、术后病理学结果均无影响，但其能够减少吻合口瘘并发症的发生。Abstract:Objective To analyze the significance and clinical application of preserving left colon artery in laparoscopic radical resection of rectal cancer.Methods A total of 100 patients who received laparoscopic radical resection of rectal cancer in our hospital from January 2017 to January 2019 were selected in the study. According to whether left colonic artery was preserved during operation, the patients were divided into control group and observation group, with 50 cases in each group. The left colon artery was not retained in the control group, while the left colon artery was retained in the observation group. The intraoperative bleeding volume, operation time, ventilation time, hospitalization time, number of lymph node dissection, pathological results and recovery were compared and analyzed between the two groups.Results There were no significant difference in bleeding volume, operation time, hospitalization time and number of lymph node dissection between the two groups (P>0.05). The postoperative ventilation time of the observation group was significantly shorter than that of the control group [(2.56±0.41) d vs. (2.81±0.53) d, P < 0.05]. There were no significant difference in histological types, TNM staging, the incidences of urinary retention and sexual dysfunction between the two groups (P>0.05). The incidence of anastomotic leakage in the observation group was significantly lower than that in the control group(P < 0.05).Conclusion Laparoscopic radical resection of rectal cancer with left colon artery preservation has no effect on intraoperative bleeding volume, operation time, ventilation time, hospitalization time, number of lymph node dissection and postoperative pathological results, but it can reduce the incidence of complications caused by anastomotic leakage.
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Keywords:
- laparoscopy /
- rectal cancer /
- radical operation /
- left colon artery /
- anastomotic fistula
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表 1 2组手术相关指标比较(x±s)
组别 n 术中出血量/mL 手术时间/min 通气时间/d 住院时间/d 淋巴结清扫数目/枚 观察组 50 112.92±30.25 169.43±32.54 2.56±0.41* 9.47±2.14 20.64±5.93 对照组 50 110.95±27.87 171.44±35.72 2.81±0.53 9.80±2.07 20.81±5.94 与对照组比较, *P < 0.05。 
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表 2 2组术后病理学结果比较[n(%)]
组别 n 组织学类型 TNM分期 低分化腺癌 中分化腺癌 高分化腺癌 黏液腺癌 Ⅰ期 Ⅱ期 Ⅲ期 观察组 50 2(4.00) 41(82.00) 2(4.00) 5(10.00) 7(14.00) 23(46.00) 20(40.00) 对照组 50 1(2.00) 42(84.00) 3(6.00) 4(8.00) 11(22.00) 20(40.00) 19(38.00)
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表 3 2组术后恢复情况比较[n(%)]
组别 n 尿潴留 吻合口瘘 性功能障碍 观察组 50 0 1(2.00)* 0 对照组 50 2(4.00) 8(16.00) 2(4.00) 与对照组比较, *P < 0.05。
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