摘要
目的分析四步法保留左结肠动脉(LCA)用于腹腔镜下直肠癌根治术的效果。方法选择2020年5月至2022年5月在上海交通大学医学院苏州九龙医院进行治疗的102例择期行腹腔镜下直肠癌根治术的患者为研究对象,按照随机数字表法将其分为观察组和对照组,各51例。观察组采用“四步法”在保留LCA基础上进行手术,对照组在不保留LCA的基础上进行手术。比较两组手术和淋巴结清扫情况、手术前后肿瘤标志物、并发症发生情况,以及1年随访情况。结果两组手术时间、术中出血量、术后排气时间、肠鸣音恢复时间、住院时间、淋巴结清扫总数、NO.253淋巴结清扫数目比较,差异无统计学意义(P>0.05)。术后两组肿瘤标志物水平较术前降低(P<0.05),两组肿瘤标志物水平比较,差异无统计学意义(P>0.05)。观察组并发症总发生率低于对照组(P<0.05)。两组术后1年癌细胞转移发生率比较,差异无统计学意义(P>0.05)。结论将四步法保留LCA用于腹腔镜下直肠癌根治术患者对其手术时间、术中出血量、淋巴结清除率,以及肿瘤标志物水平无明显影响,但保留LCA可降低并发症发生风险。
Objective To analyze the effect of four-step left colic artery(LCA)preservation in laparoscopic radical resection of rectal cancer.Methods A total of 102 patients undergoing laparoscopic radical resection of rectal cancer who were treated in Shanghai Jiao Tong University School of Medicine Suzhou Kowloon Hospital,from May 2020 to May 2022 were selected as the study objects,and they were divided into observation group and control group according to random number table method,with 51 cases in each group.The observation group was operated on the basis of preserving LCA by“four-step method”,while the control group was operated on the basis of not retaining LCA.The operation and lymph node dissection,levels of tumor markers before and after operation,incidence of complications,and 1-year follow-up were compared between the two groups.Results There was no significant difference in operation time,intraoperative blood loss,postoperative exhaust time,bowel sound recovery time,hospital stay,total number of lymph node dissection,and number of NO.253 lymph node dissection between the two groups(P>0.05).After surgery,the level of tumor markers in the two groups was lower than those before surgery(P<0.05),and there was no statistical significance in the level of tumor markers between the two groups(P>0.05).The total complication rate of observation group was lower than that of control group(P<0.05).There was no significant difference in the incidence of cancer cell metastasis one year after surgery between the two groups(P>0.05).Conclusion Four-step LCA retention has no significant effect on the operation time,blood loss,lymph node clearance,and tumor marker level in patients undergoing laparoscopic radical resection for rectal cancer,but LCA retention significantly reduced the risk of complications.
作者
毛郁琪
常剑
邱峰
MAO Yuqi;CHANG Jian;QIU Feng(Department of General Surgery,Shanghai Jiao Tong University School of Medicine Suzhou Kowloon Hospital,Jiangsu Province,Suzhou 215000,China)
出处
《中国医药导报》
CAS
2024年第11期93-96,共4页
China Medical Herald
基金
江苏省高等学校自然科学研究项目(18KJB320018)。
关键词
左结肠动脉
腹腔镜
直肠癌根治术
淋巴结清除
Left colic artery
Laparoscopy
Radical resection of rectal cancer
Lymph node dissection
