【摘要】 目的评价保留左结肠动脉在腹腔镜直肠癌根治术中的应用效果。方法通过文献回溯及检索国内外数据库等方法检索自建库以来至2018年6月的腹腔镜保留左结肠动脉的直肠癌根治术随机对照文献,经筛选后共纳入8篇,共计713例患者,术中保留左结肠动脉359例,术中不保留左结肠动脉354例。采用Cochrane协作网Revman5.3软件对两组患者术中术后情况进行Meta分析。结果保留组术中边缘动脉弓压力、预防性回肠造口情况及术后首次排气时间、吻合口瘘发生率情况均优于不保留组,差异具有统计学意义(P<0.05)。两组患者手术时间、术中出血量、淋巴结清扫数、游离脾曲率,术后吻合口出血率、复发率、转移率、生存率等差异无统计学意义(P>0.05)。结论腹腔镜直肠癌根治术中保留左结肠动脉能改善吻合口血供,降低预防性造口及吻合口瘘发生率,促进胃肠功能恢复。更多还原

【Abstract】 Objective To evaluate the effect of left colon artery(LCA)perservation in laparoscopic rectal anterior resection.Methods The literature searches since the establishment of the datebase to June 2018 was performed to retrieve all randomized controlled trials of laparoscopic resection for rectal cancer in the preservation of left colic artery. A total of 8 randomized controlled trials(713 patients) were located. There were 359 patients in the left colon artery preservation group and 354 patients in the non-preservation group. All data during and after operation of two groups were Meta-analyzed by Revman 5.3 software.Results The marginal artery arch pressure, prophylactic ileostomy, postoperative initial anal exhaust time and the incidence of anastomotic fistual in the LCA preservation groups were significantly better than those in the LCA non-preservation groups(P<0.05).The length of operation, intraoperative blooding, number of dissected lymph nodes, splenic flexure dissociation, the incidence of postoperative anastomotic bleeding, postoperative tumor recurrence and metastasis and survival rate showed no significant differences between the experimental groups and controlled groups(P>0.05).Conclusions Laparoscopic resection for rectal cancer in the preservation of left colic artery can effectively improve the blood supply of anastomotic stoma and reduce the incidence of prophylactic ileostomy and postoperative anastomotic fistula, which promotes the recovery of gastrointestinal function.更多还原