摘要
目的:探究腹腔镜直肠癌前切除术(LAR)保留左结肠动脉(LCA)对患者肠胃功能及术后并发症。方法:回顾性分析2019年1月至2022年1月我院行LAR的105例患者临床资料,根据LCA处理方式分为保留组54例(保留LCA)和未保留组51例(不保留LCA)。比较两组患者手术指标、淋巴清扫情况,对比术前和术后2d,两组患者肠胃功能[胃泌素(GAS)、胃动素(MTL)]及肛门功能[Wexner便秘评分(WCS)],统计两组患者并发症发生情况。结果:保留组手术时间长于未保留组,且并发症发生率低于未保留组(P均<0.05);两组出血量、拔管时间、术后引流量、住院时间、淋巴结清扫量、GAS、MTL水平及WCS评分差异不显著(P均>0.05)。结论:LAR保留LCA不影响直肠癌患者淋巴结清扫、胃肠功能及肛门功能,但可减少并发症发生。
Objective:To investigate the effects of laparoscopic anterior resection(LAR)with preservation of the left colic artery(LCA)on gastrointestinal function and postoperative complications in patients with rectal cancer.Methods:A retrospective analysis was conducted on the clinical data of 105 patients who underwent LAR in our hospital from January 2019 to January 2022.Based on the treatment of LCA,patients were divided into the preservation group(54 cases,preserving LCA)and the non-preservation group(51 cases,not preserving LCA).Surgical parameters,lymph node dissection,preoperative and postoperative 2-day gastrointestinal function[gastrin(GAS),motilin(MTL)],and anal function[Wexner constipation score(WCS)]were compared between the two groups.The occurrence of complications in both groups was also recorded.Results:The preservation group had a longer operation time than the non-preservation group,and the incidence of complications was lower in the preservation group(both P<0.05).There were no significant differences in blood loss,extubation time,postoperative drainage,length of hospital stay,lymph node dissection,GAS,MTL levels,and WCS scores between the two groups(all P>0.05).Conclusion:Preserving the LCA during LAR for rectal cancer does not affect lymph node dissection,gastrointestinal function,or anal function.Moreover,it may reduce the incidence of postoperative complications.
作者
琚然
刘平
缪琦
JU Ran;LIU Ping;MIAO Qi(The Affiliated Chuzhou Hospital of Anhui Medical University,Anhui Chuzhou 239000,China)
出处
《河北医学》
2024年第1期76-80,共5页
Hebei Medicine
基金
2019年安徽省重点研究与开发计划项目,(编号:201904a07020085)。
关键词
腹腔镜直肠癌前切除术
左结肠动脉
吻合口漏
吻合口近端肠管缺血坏死
淋巴结清扫
肠胃功能
Laparoscopic anterior resection
Left colic artery
Anastomotic leakage
Proximal intestinal ischemic necrosis at anastomotic site
Lymph node dissection
Gastrointestinal function
