摘要
目的探讨腹腔镜下直肠癌低位前切除术保留与不保留直肠上动脉和左结肠动脉对患者康复的影响.方法将110例直肠癌患者按随机数字表法分为两组,每组55例.两组均行腹腔镜下直肠癌低位前切除术,对照组不保留直肠上动脉和左结肠动脉,观察组保留直肠上动脉和左结肠动脉.比较两组患者手术时间、术中出血量、淋巴结清扫数量、术中并发症、术后并发症、术后肠道功能恢复时间、术后住院时间、淋巴结转移、局部复发等情况.结果(1)术中情况:观察组手术时间显著长于对照组(P<0.01),术中出血量显著多于对照组(P<0.01),两组淋巴结清扫数量及术中并发症发生率比较差异无统计学意义(P>0.05).(2)术后恢复情况:观察组术后住院时间显著少于对照组(P<0.01),术后首次排便时间显著早于对照组(P<0.05),两组术后首次排气时间比较差异无统计学意义(P>0.05).(3)并发症及预后情况:观察组术后并发症发生率显著低于对照组(P<0.05),两组转移及复发率比较差异无统计学意义(P>0.05).结论采用保留直肠上动脉和左结肠动脉的腹腔镜下直肠癌低位前切除术能有效促进患者术后恢复,减少严重术后并发症的发生,安全性高.
Objective To study the effect of laparoscopic rectal cancer low anterior resection with or without preservation of the superior rectal artery and left colon artery.Methods 110 rectal cancer patients were divided into two groups according to the order of admission,55 cases each.Both groups underwent laparoscopic rectal cancer low anterior resection.The control group did not retain the superior rectal and left colon arteries,and the observation group retained the superior rectal and left colon arteries.The operation time,intraoperative blood loss,number of lymph node dissections,intraoperative complications,postoperative complications,postoperative intestinal function recovery time,postoperative hospital stay,lymph node metastasis,and local recurrence were compared between the two groups.Results(1)Intraoperative situation:The observation group had significantly longer operation time than the control group(P<0.01),and the intraoperative blood loss was significantly more than the control group(P<0.01).There was no significant difference in the number of lymph node dissections and the incidence of intraoperative complications between the two groups(P>0.05).(2)Postoperative recovery:The length of postoperative hospital stay was significantly shorter than that of the control group(P<0.01),and the first postoperative defecation time was significantly earlier than that of the control group(P<0.05).There was no significant difference in the first exhaust time between the two groups(P>0.05).(3)Complications and prognosis:The incidence of postoperative complications was significantly lower in the observation group than in the control group(P<0.05),and there was no significant difference in metastasis and recurrence rates between the two groups(P>0.05).Conclusions Laparoscopic radical resection of rectal cancer with preservation of superior rectal artery and left colon artery can effectively promote postoperative recovery,reduce the occurrence of serious postoperative complications,and is highly safe.
作者
黄涛
魏林
于民
Huang Tao;Wei Lin;Yu Min(Zhumadian First People's Hospital,Zhumadian 463000,Henan,China)
出处
《临床心身疾病杂志》
CAS
2020年第3期150-152,195,共4页
Journal of Clinical Psychosomatic Diseases
关键词
直肠癌
腹腔镜
直肠癌根治术
直肠上动脉
左结肠动脉
吻合口瘘
Rectal cancer
laparoscopy
radical surgery
superior rectal artery
left colon artery
anastomotic fistula
作者简介
黄涛,男,42岁,汉族,本科,副主任医师。主要研究成果:发表专业论文10篇。研究方向:外科手术治疗。
