保留左结肠动脉的腹腔镜直肠前切除术的可行性研究

目的探讨根部结扎与腹腔镜直肠前切除术的可行性。 方法回顾性分析2015年9月至2019年9月直肠癌患者74例资料，根据手术方法不同将其分为两组，对照组进行肠系膜下动脉的根部结扎不保留左结肠动脉，研究组进行保留左结肠动脉高清腹腔镜直肠前切除术，每组37例。应用SPSS20.0软件处理数据，术中术后指标、肠管远、近切缘长度、淋巴结清扫数目以( ±s)表示，独立t检验；术后并发症采用χ²检验，P<0.05差异有统计学意义。 结果研究组术中出血量和手术时间多于对照组(P<0.05)，但术后排气时间少于对照组(P<0.05)；两组肠管远切缘长度、肠管近切缘长度、第3站淋巴结清扫数目、淋巴结清扫总数目、术后并发症发生率等差异无统计学意义(P>0.05)。 结论直肠癌的治疗中，保留左结肠动脉将会更多应用于临床，治疗效果较好，应进一步推广。

Clinical investigation of the feasibility of laparoscopic anterior resection with the preservation of left colon artery

ObjectiveTo explore the feasibility of laparoscopic anterior resection with the preservation of left colon artery. MethodsFrom September 2015 to September 2019, the clinical data of 74 patients with rectal cancer were analyzed retrospectively, who were divided into study group (n=37) and control group (n=37) according to with or without the preservation of left colon artery. Statistical analysis were performed by using SPSS 20.0 software. Measurement data, including perioperative indicators, distal and proximal resection margin distance, and harvested lymph nodes were expressed as ( ±s) and were examined by using independent sample t test. Postoperative complications were analyzed by using χ² test. A P value <0.05 was considered as statistically significant difference. ResultsThe bleeding volume and operation time of the study group were more than those of the control group respectively (P<0.05), while the postoperative exhaust time was shorter than that of the control group, with significant difference (P<0.05). There was no significant difference between χ² groups in terms of harvested lymph nodes (D3 or total) as well as the incidence of postoperative complications (P>0.05). ConclusionIn laparoscopic anterior resection of rectal cancer, the preservation of the left colon artery could achieve better clinical outcome and should be further promoted in clinical application.