Corder A P, Karanjia N D, Williams J D, Heald R J
Colorectal Research Unit, Basingstoke District Hospital, UK.
Br J Surg. 1992 Jul;79(7):680-2. doi: 10.1002/bjs.1800790730.
The effects of two methods of colonic vascular ligation were studied in 143 consecutive patients who underwent low anterior resection with total mesorectal excision and full mobilization of the splenic flexure. Either the ascending left colic artery (ALCA) was selectively preserved (n = 52) or a flush aortic ligation was performed (n = 91). In those with a protective colostomy, the radiological leak rate was 12 per cent when the ALCA was preserved (n = 41) and 10 per cent when a flush aortic tie was performed (n = 60) (P greater than 0.95; 95 per cent confidence interval (c.i.) for difference -10 to +15 per cent). In those without a colostomy, the clinical leak rates of 9 per cent when the ALCA was preserved (n = 11) and 19 per cent when a flush aortic tie was performed (n = 31) were not significantly different (P greater than 0.10; 95 per cent c.i. for difference -12 to +32 per cent). Proportional hazards analysis showed no association between the method of vascular ligation and the risk of tumour recurrence and death. Anastomotic leak rates, tumour recurrence and survival were not related to the method of vascular ligation.
对143例连续接受低位前切除术、全直肠系膜切除术及脾曲完全游离术的患者，研究了两种结肠血管结扎方法的效果。要么选择性保留升左结肠动脉（ALCA）（n = 52），要么进行主动脉平齐结扎（n = 91）。在有保护性结肠造口的患者中，保留ALCA时放射学渗漏率为12%（n = 41），进行主动脉平齐结扎时为10%（n = 60）（P>0.95；差异的95%置信区间（c.i.）为-10%至+15%）。在没有结肠造口的患者中，保留ALCA时临床渗漏率为9%（n = 11），进行主动脉平齐结扎时为19%（n = 31），差异无统计学意义（P>0.10；差异的95% c.i.为-12%至+32%）。比例风险分析显示，血管结扎方法与肿瘤复发和死亡风险之间无关联。吻合口渗漏率、肿瘤复发和生存率与血管结扎方法无关。
