保留左结肠动脉的腹腔镜低位直肠癌前切除术

发布时间：2018-05-07 08:32

本文选题：低位直肠癌 + 左结肠动脉　；参考：《中国微创外科杂志》2017年09期

【摘要】：目的探讨腹腔镜低位直肠癌前切除术中处理肠系膜下动脉(inferior mesenteric artery,IMA)时保留左结肠动脉(left colonic artery,LCA)的可行性及临床价值。方法回顾性分析我院2010年5月~2014年10月85例腹腔镜低位直肠癌前切除术的临床资料,其中保留LCA 44例,IMA根部结扎(不保留LCA)41例,比较2组临床病理资料、手术效果及术后并发症。结果 2组手术时间、术中出血量、术后排气时间、第3站淋巴结清扫数目及转移率均无显著性差异(P0.05)。保留LCA组无游离脾曲及末端回肠造口,不保留LCA组6例游离脾曲(P=0.010),3例行末端回肠造口(P=0.108)。2组术后吻合口漏、复发、转移率差异无统计学意义(P0.05)。结论腹腔镜低位直肠癌前切除术保留LCA可以保障近端结肠血运,保证第3站淋巴结根治性。
[Abstract]:Objective to investigate the feasibility and clinical value of preserving left mesenteric artery of left colonic artery during laparoscopic anterior resection of low rectal cancer. Methods the clinical data of 85 cases of laparoscopic anterior resection of low rectal cancer from May 2010 to October 2014 in our hospital were retrospectively analyzed. Among them, 44 cases with LCA were treated with LCA root ligation (no preservation of LCA)41), and the clinicopathological data of the two groups were compared. Results of operation and postoperative complications. Results there was no significant difference in operation time, blood loss, postoperative exhaust time, the number of lymph node dissection and metastasis rate between the two groups (P 0.05). There was no free splenic curvature and terminal ileostomy in LCA group, and there was no significant difference in anastomotic leakage, recurrence and metastasis rate between 6 cases of LCA group and 3 cases of P0. 0108t0. 2 terminal ileostomy group (P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%). Conclusion Laparoscopic anterior resection of low rectal cancer with LCA can protect proximal colon blood supply and ensure radical lymph node resection at the third station.
【作者单位】：湖北文理学院附属襄阳市中心医院普外科;
【基金】：襄阳市科技局课题(襄科计[2014]9-1)
【分类号】：R735.37

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