[1]赖海平,蔡联明,刘振华,等.保留左结肠动脉腹腔镜全直肠系膜切除术治疗中低位直肠癌的疗效及对肛门功能的影响[J].医学信息官方网站,2022,35(15):117-120.[doi:10.3969/j.issn.1006-1959.2022.15.027]
　LAI Hai-ping,CAI Lian-ming,LIU Zhen-hua,et al.Effect of Laparoscopic Total Mesorectal Excision with Left Colonic Artery Preservation for Middle and Low Rectal Cancer and its Effect on Anal Function[J].Medical Information,2022,35(15):117-120.[doi:10.3969/j.issn.1006-1959.2022.15.027]
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保留左结肠动脉腹腔镜全直肠系膜切除术治疗中低位直肠癌的疗效及对肛门功能的影响()
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《医学信息》官方网站[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年15期
页码:
117-120
栏目:
论著
出版日期:
2022-08-01

文章信息/Info

Title:
Effect of Laparoscopic Total Mesorectal Excision with Left Colonic Artery Preservation for Middle and Low Rectal Cancer and its Effect on Anal Function
文章编号:
1006-1959（2022）15-0117-04
作者:
赖海平; 蔡联明; 刘振华; 等
（赣州市肿瘤医院腹部外科，江西 赣州 341000）
Author(s):
LAI Hai-ping; CAI Lian-ming; LIU Zhen-hua; et al.
(Department of Abdominal Surgery,Ganzhou Cancer Hospital,Ganzhou 341000,Jiangxi,China)
关键词:
中低位直肠癌; 腹腔镜全直肠系膜切除术; 左结肠动脉; 肛门功能; 吻合口漏
Keywords:
Middle and low rectal cancer; Laparoscopic total mesorectal resection; Left colon artery; Anal function; Anastomotic leakage
分类号:
R735.37
DOI:
10.3969/j.issn.1006-1959.2022.15.027
文献标志码:
A
摘要:
目的 研究保留左结肠动脉（LCA）腹腔镜全直肠系膜切除术（TME）治疗中低位直肠癌患者的并发症，以及其对肛门功能的影响。方法 选取2019年1月-2021年6月赣州市肿瘤医院腹部外科收治的72例中低位直肠癌患者，按照随机数字表法分为对照组与观察组，各36例。两组均采用腹腔镜TME治疗，对照组不保留LCA，观察组保留LCA。比较两组肿瘤根治性指标（清扫淋巴结数目、肠管近切缘长度、肠管远切缘长度）、围术期指标、并发症情况、保肛率、肛门功能[肠管最大收缩压（AMSP）、肛管静息压（ARP）、直肠最大耐受量（RMTV）]及预后情况。结果 两组清扫淋巴结数目、肠管近切缘长度、肠管远切缘长度比较，差异无统计学意义（P＞0.05）；两组手术时间、术中出血量、术后肠功能恢复时间比较，差异无统计学意义（P＞0.05）；观察组并发症发生率低于对照组（P＜0.05）；观察组保肛率高于对照组，且RMTV高于对照组（P＜0.05）；两组局部复发率及远处转移比较，差异无统计学意义（P＞0.05）。结论 中低位直肠癌TME术中保留LCA安全可行，可保证手术根除效果，降低术后并发症风险，同时提高患者保肛率，减少手术对肛门功能的影响，不增加复发及转移风险。
Abstract:
Objective To study the complications of laparoscopic total mesorectal excision (TME) with left colon artery (LCA) preservation in the treatment of middle and low rectal cancer and its influence on anal function.Methods A total of 72 patients with middle and low rectal cancer admitted to Department of Abdominal Surgery, Ganzhou Cancer Hospital from January 2019 to June 2021 were randomly divided into control group and observation group, with 36 cases in each group. Both groups were treated with laparoscopic TME. The control group did not retain LCA, and the observation group retained LCA. The radical indicators of tumor (number of lymph node dissection, length of proximal and distal intestine), perioperative indicators, complications, anal preservation rate, anal function [maximum intestinal systolic pressure (AMSP), anal resting pressure (ARP), rectal maximum tolerance (RMTV)] and prognosis were compared between the two groups.Results There was no significant difference in the number of lymph nodes, the length of the proximal resection margin of the bowel, and the length of the distal resection margin of the bowel between the two groups (P>0.05). There was no statistically significant difference in operation time, intraoperative blood loss, and postoperative bowel function recovery time between the two groups (P>0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05). The anus preservation rate of the observation group was higher than that of the control group, and the RMTV was higher than that of the control group (P<0.05). There was no significant difference in the local recurrence rate and distant metastasis between the two groups (P>0.05).Conclusion It is safe and feasible to retain LCA during TME operation for middle and low rectal cancer, which can ensure the eradication effect and reduce the risk of postoperative complications. At the same time, it can increase the patient’s anus preservation rate, reduce the impact of surgery on anal function, and will not increase the risk of recurrence and metastasis.

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更新日期/Last Update: 1900-01-01