【摘要】 目的探讨保留左结肠动脉的腹腔镜直肠癌手术对患者预后的影响。方法选取2012年12月至2016年12月在我院行腹腔镜直肠癌根治术的患者63例进行回顾性分析,根据术中是否保留左结肠动脉分为两组,对照组不保留左结肠动脉,观察组保留左结肠动脉。比较两组患者围术期相关指标、术后恢复情况、手术结果及复发和转移情况。结果两组患者的手术时间、术中出血量、淋巴结清扫数目、肿瘤直径、吻合口距齿状线距离、术后排气时间、下床活动时间和住院时间相比无统计学差异(P> 0.05);两组患者切口感染、肠梗阻和腹腔感染的发生率无统计学差异(P> 0.05),观察组吻合口瘘发生率、残端缺血性改变例数和游离脾曲显著低于对照组(P <0.05)。两组患者的复发率和转移率比较无统计学差异(P> 0.05)。结论保留左结肠动脉的腹腔镜直肠癌手术可完成与不保留左结肠动脉的腹腔镜直肠癌手术同样的淋巴结清扫,不增加患者的远期复发率和转移率,可显著降低吻合口瘘发生率、残端缺血性改变例数和游离脾曲,有利于患者康复。更多还原

【Abstract】 Objective To explore the effect of laparoscopic rectal surgery with left colonic artery reservation on the prognosis of patients. Methods A retrospective analysis was performed on 63 patients who underwent laparoscopic rectal cancer radical resection in our hospital from December 2012 to December 2016.According to whether left colon artery was retained during operation, they were divided into two groups. The control group did not retain left colon artery, while the observation group retained left colon artery. The perioperative correlative indexes, postoperative recovery, operation result, recurrence and metastasis were compared between the two groups. Results There were no statistically significant differences between the two groups in operation time, intraoperative blood loss, number of lymph node dissection, distance from dentate line to anastomotic site, postoperative exhaust time, diameter of tumor and hospitalization time( P > 0. 05).There was no significant difference in postoperative exhaust time, out of bed activity time and hospital stay between the two groups( P > 0.05).There was no statistical difference in the incidence of incision infection,intestinal obstruction and abdominal infection between the two groups( P > 0.05). The incidence of anastomotic leakage, residual ischemic changes and free splenic melody in the observation group were significantly lower than those in the control group( P < 0. 05). There was no significant difference in the recurrence rate and metastasis rate between the two groups( P > 0.05). Conclusion Laparoscopic rectal cancer surgery with left colon artery reservation can complete the same lymph node dissection as laparoscopic rectal cancer surgery without left colon artery reservation, without increasing the long-term recurrence rate and metastasis rate of the patients, and significantly reduce the incidence of anastomotic leakage and residual ischemic changes, which is conducive to the patients’ rehabilitation.更多还原