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在腹腔镜手术中保留左结肠动脉和直肠上动脉可减少乙状结肠癌的吻合口漏。

Preservation of the left colic artery and superior rectal artery in laparoscopic surgery can reduce anastomotic leakage in sigmoid colon cancer.

作者信息

Tang Xiaolong, Zhang Mengjun, Wang Chao, He Qingsi, Sun Guorui, Qu Hui

机构信息

Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.

Department of General Surgery, Lanling People's Hospital, Linyi, China.

出版信息

J Minim Access Surg. 2021 Apr-Jun;17(2):208-212. doi: 10.4103/jmas.JMAS_15_20.

Abstract

BACKGROUND

The aim was to study the clinical significance in the preservation of the left colic artery (LCA) and superior rectal artery (SRA) for the laparoscopic resection of sigmoid colon cancer (SCC).

PATIENTS AND METHODS

A total of 316 patients with SCC were divided into two groups. Group A received D3 resection with preservation of LCA and SRA, whereas Group B ligatured artery at the root of the inferior mesenteric artery. The operation time, number of resected lymph nodes, blood loss and anastomotic leakage rate were compared.

RESULTS

In Group A, the average operation time was 283.02 ± 51.48 min, the average blood loss was 111.81 ± 77.08 ml and the average lymph node dissection was 14.8 ± 7.7. There was no statistical significance in blood loss and number of resected lymph nodes between Group A and B (P > 0.05). Longer operating time were observed in Group A as compared to Group B (P < 0.05). The anastomotic leakage rate had statistical significance between these two groups (P < 0.05).

CONCLUSIONS

Preservation of LCA and SRA was safe and feasible for the laparoscopic surgery of SCC, which could reduce anastomotic leakage rate.

摘要

背景

本研究旨在探讨保留左结肠动脉(LCA)和直肠上动脉(SRA)在腹腔镜乙状结肠癌(SCC)切除术中的临床意义。

患者与方法

316例SCC患者分为两组。A组行保留LCA和SRA的D3根治术,B组在肠系膜下动脉根部结扎动脉。比较两组手术时间、切除淋巴结数目、术中出血量及吻合口漏发生率。

结果

A组平均手术时间为283.02±51.48分钟,平均出血量为111.81±77.08毫升,平均清扫淋巴结数为14.8±7.7枚。A组与B组术中出血量及切除淋巴结数目差异无统计学意义(P>0.05)。A组手术时间较B组长(P<0.05)。两组吻合口漏发生率差异有统计学意义(P<0.05)。

结论

保留LCA和SRA用于腹腔镜SCC手术安全可行,可降低吻合口漏发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ca0/8083730/30d9162e9cf5/JMAS-17-208-g001.jpg

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