不同左结肠动脉处理方案对腹腔镜下行低位前切除术直肠癌患者预后的影响

目的探讨不保留和保留左结肠动脉方案对腹腔镜下行低位前切除术直肠癌患者复发转移及远期生存的影响。方法收集2011年1月至2013年12月腹腔镜下行低位前切除术的直肠癌患者135例,根据手术方案分为不保留左结肠动脉组(n=75)和保留左结肠动脉组(n=60),分别采用不保留和保留左结肠动脉方案。比较两组患者术后5年复发率、5年转移率、5年生存率和5年无病生存率。结果不保留左结肠动脉组患者的术后5年复发率和5年转移率分别为8.0%(6/75)和37.3%(28/75),保留左结肠动脉组患者的术后5年复发率和5年转移率分别为6.7%(4/60)和40.0%(24/60),两组比较差异均无统计学意义(P>0.05)。不保留左结肠动脉组患者的5年生存率和5年无病生存率分别为70.7%和60.0%,保留左结肠动脉组患者的5年生存率和5年无病生存率分别为68.3%和56.7%,两组比较差异均无统计学意义(P>0.05)。结论保留左结肠动脉方案用于腹腔镜下行低位前切除术的直肠癌患者在复发转移和远期生存方面与不保留左结肠动脉方案接近。

Influence of different left colonic artery management protocols on prognosis of rectal cancer patients undergoing low anterior resection of laparoscopy

Objective To investigate the influence of left colonic artery ligature or preservation on recurrence,metastasis and survival of rectal cancer patients undergoing low anterior resection of laparoscopy.Methods A total of 135 rectal cancer patients undergoing low anterior resection of laparoscopy from January 2011 to December 2013 were enrolled.Based on the management of left colonic artery,there were 75 patients in left colonic artery ligature group with the treatment of left colonic artery ligature and 60 patients in left colonic artery preservation group with left colonic artery preservation management.The 5-year postoperative recurrence rate,5-year postoperative metastatic rate,5-year overall survival rate and 5-year disease-free survival rate were analyzed.Results The 5-year postoperative recurrence rate and 5-year postoperative metastatic rate of left colonic artery ligature group were 8.0%(6/75)and 37.3%(28/75).Those data of left colonic artery preservation group were 6.7%(4/60)and 40.0%(24/60).There was no significant difference between the two groups(P>0.05).The 5-year overall survival rate and 5-year disease-free survival rate of left colonic artery ligature group were 70.7%and 60.0%.Those data of left colonic artery preservation group were 68.3%and 56.7%.There was no significant difference between the two groups(P>0.05).Conclusion Left colonic artery ligature or preservation in the treatment of rectal cancer patients undergoing low anterior resection of laparoscopy possess the similar clinical benefits on recurrence,metastatic risk and long-term survival.