Zhang Y D, Qu H, Du Y F, Xie D H, Li M Z, Shen J
Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Zhonghua Yi Xue Za Zhi. 2016 Jun 28;96(24):1916-8. doi: 10.3760/cma.j.issn.0376-2491.2016.24.009.
To investigate the clinical possibility of low ligation of inferior mesenteric artery (IMA) and lymph nodes dissection in laparoscopic low anterior resection.
Data was collected retrospectively from 216 patients who underwent laparoscopic low anterior resection in our hospital from June 2011 to January 2015.Patients were divided into control group (132 cases) and observation group (84 cases). The observation group was treated with low ligation of IMA and lymph nodes dissection, and the control group was cured by high ligation of IMA and lymph nodes dissection. We analyzed the operation time, the number of lymph nodes dissection, the number of lymph nodes removed around the root of IMA, the rate of lymph node metastasis around the root of IMA, the incidence of anastomotic leakage and the ventilation time after the operation.
There was no significant difference between the two group in the pre-operative data, operation time, the number of lymph nodes dissection the number of lymph nodes removed around the root of IMA, the rate of lymph node metastasis around the root of IMA and the incidence of anastomotic leakage (P>0.05). The observation group were significantly better than the control group the in the ventilation time after the operation (P<0.05). The follow up time was 12 to 67 months. The median follow up time was 37 months. One patient in observation group died of cardiovascular disease. One patient in control group died of metastatic carcinoma.
Detection of low ligation of inferior mesenteric artery and lymph nodes dissection in laparoscopic low anterior resection is safe and practicable, which should be widely applied.
探讨腹腔镜低位前切除术中肠系膜下动脉（IMA）低位结扎及淋巴结清扫的临床可行性。
回顾性收集2011年6月至2015年1月在我院行腹腔镜低位前切除术的216例患者的数据。将患者分为对照组（132例）和观察组（84例）。观察组采用IMA低位结扎及淋巴结清扫治疗，对照组采用IMA高位结扎及淋巴结清扫治疗。分析手术时间、淋巴结清扫数目、IMA根部周围清扫淋巴结数目、IMA根部周围淋巴结转移率、吻合口漏发生率及术后通气时间。
两组患者术前数据、手术时间、淋巴结清扫数目、IMA根部周围清扫淋巴结数目、IMA根部周围淋巴结转移率及吻合口漏发生率比较，差异均无统计学意义（P>0.05）。观察组术后通气时间明显优于对照组（P<0.05）。随访时间为12至67个月，中位随访时间为37个月。观察组1例患者死于心血管疾病，对照组1例患者死于转移性癌。
腹腔镜低位前切除术中肠系膜下动脉低位结扎及淋巴结清扫安全可行，应广泛应用。
