Ding Chuang, Kong Lingyong, Zhang Ming, Chen Yan
Chuang Ding, Department of Gastrointestinal Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu, China.
Lingyong Kong, Department of Gastrointestinal Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu, China.
Pak J Med Sci. 2023 Jan-Feb;39(1):139-143. doi: 10.12669/pjms.39.1.6366.
To investigate the effect of different treatment methods of the left colic artery (LCA) on postoperative rehabilitation of patients undergoing laparoscopic radical resection of rectal cancer.
Retrospective analysis was performed on 70 patients undergoing laparoscopic radical resection of rectal cancer who were admitted to The Affiliated Suqian Hospital of Xuzhou Medical University from January, 2020 to December, 2022 were selected and divided into two groups according to different treatment methods of LCA. The preservation group (LCA group) (n=34 cases) and the non-preservation group (NLCA group) (n=36 cases). Both groups were treated with laparoscopic radical resection of rectal cancer. IMA was preserved in the LCA group, but not in the NLCA group. The efficacy indicators, surgical treatment and rehabilitation-related indicators, gastrointestinal hormone indicators (motilin (MTL), gastrin (GAS)), and postoperative complications risk were compared between the two groups before and after surgery.
No statistically significant difference was observed between the two groups in terms of efficacy indicators (total number of lymph nodes dissected and number of lymph nodes at the root of the IMA), operation time, intraoperative blood loss, and postoperative drainage tube placement time (p>0.05). However, postoperative anal flatus and hospital stay in the LCA group were considerably shorter than those in the NLCA group (p<0.05). Postoperatively, the levels of MTL and GAS in the two groups were significantly decreased, and the LCA group decreased slightly compared with the NLCA group (p<0.05). Moreover, the incidence of complications in the LCA group (5.88%) was significantly lower than that in the NLCA group (27.78%) (p<0.05).
Preservation of LCA and no-preservation of LCA in laparoscopic radical resection of rectal cancer are comparable in terms of therapeutic effect, and the surgery with preservation of LCA is worthy of clinical promotion due to its various benefits such as less impact on gastrointestinal hormone indicators, lower risk of complications, and faster postoperative recovery.
探讨左结肠动脉(LCA)不同处理方法对腹腔镜直肠癌根治术患者术后康复的影响。
回顾性分析2020年1月至2022年12月徐州医科大学附属宿迁医院收治的70例行腹腔镜直肠癌根治术的患者,根据LCA不同处理方法分为两组。保留组(LCA组)(n = 34例)和非保留组(NLCA组)(n = 36例)。两组均行腹腔镜直肠癌根治术。LCA组保留IMA,NLCA组不保留IMA。比较两组手术前后的疗效指标、手术治疗及康复相关指标、胃肠激素指标(胃动素(MTL)、胃泌素(GAS))及术后并发症风险。
两组在疗效指标(清扫淋巴结总数及IMA根部淋巴结数)、手术时间、术中出血量及术后引流管放置时间方面差异无统计学意义(p > 0.05)。然而,LCA组术后肛门排气时间和住院时间明显短于NLCA组(p < 0.05)。术后,两组MTL和GAS水平均显著降低,且LCA组较NLCA组降低幅度稍小(p < 0.05)。此外,LCA组并发症发生率(5.88%)明显低于NLCA组(27.78%)(p < 0.05)。
腹腔镜直肠癌根治术中保留LCA与不保留LCA在治疗效果方面相当,且保留LCA的手术对胃肠激素指标影响较小、并发症风险较低、术后恢复较快等优点,值得临床推广。