摘要
目的：探讨腹腔镜辅助直肠癌根治术肠系膜下动脉最适离断平面。方法：对比分析2008年7月-2012年1月腹腔镜辅助直肠癌根治术中肠系膜下动脉不同离断平面患者的临床资料。结果：术中经肠系膜下动脉根部结扎离断血管（334例）与远离根部2-4cm处结扎离断血管（153例）比较，前者在处理肠系膜下动脉平均手术时间（7．8minvs12．6min），处理肠系膜下动脉处平均出血量（4．8mL vs 12．5mL），平均肠系膜下动脉及腹主动脉周围淋巴结清除数（12．5枚vs10．9枚）均有明显优势，差异均有统计学意义（均P〈0．01），而两者肠系膜下神经损伤率无明显差异（P〉0．05），均无肠管血供障碍。结论：行腹腔镜辅助直肠癌根治术，肠系膜下动脉于根部结扎离断是安全可靠的。并有手术时间较短，术中出血量少，局部淋巴结清扫彻底等优点。
Objective： To identify the most suitable plane for assisted radical resection of rectal cancer. division of the inferior mesenteric artery in laparoscopic- Methods： The clinical data of rectal cancer patients from July 2008 to January 2012, who underwent laparoscopic-assisted radical resection with the division of the inferior mesenteric artery in different planes, were comparatively analyzed. Results： In patients with vascular division at the root of the inferior mesenteric artery during surgery （334 cases）, the parameters that included the average operative time （7.8 min vs.12.6 min） and average blood loss （4.8 mL vs.12.5 mL） in management of the inferior mesenteric artery3 and the average number of dissected lymph nodes around the inferior mesenteric artery and abdominal aorta （12.5 vs.10.9） were all significantly better than those in patients with vascular division at a point 2-4 cm distant from the root of the inferior mesenteric artery （153 cases）, and all the differences had statistical significance （all P〈0.01）. There was no significant difference in the incidence of injury of inferior mesenteric plexus between the two procedures （P〉0.05）, and no intestinal ischemia occurred in any of the patients. Conclusion： Division at the root of the inferior mesenteric artery in performing laparoscopic-assisted radical resection of rectal cancer is safe and reliable. Moreover, it has the advantages of shorter operative time, less blood loss and adequate lymph node clearance.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2012年第10期1205-1207,共3页
China Journal of General Surgery
