摘要
目的探究“四步法”清扫No.253淋巴结在保留左结肠动脉(LCA)的直肠癌根治术中的应用效果。方法前瞻性选取2020年1月至2021年5月90例接受腹腔镜直肠癌根治术的患者,按数字表法随机分为两组,每组各45例,术中均行肠系膜下动脉(IMA)低位结扎保留LCA并行No.253淋巴结清扫。对照组行传统方法清扫No.253淋巴结,观察组行“四步法”清扫No.253淋巴结。采用软件SPSS 19.0分析数据,围手术期相关指标、No.253淋巴结清扫等指标采用(x±s)表示,行独立样本t检验;并发症发生情况用[例(%)]表示,行x^(2)检验;Kaplan-Meier法分析预后生存,行Log-Rank检验。P<0.05为差异有统计学意义。结果观察组患者手术时间短于对照组(P<0.05);两组患者其余围手术期指标、淋巴结清扫情况、术后并发症发生率、术后复发率、转移率及累积3年总生存率,差异均未见统计学意义(P>0.05)。结论保留LCA的腹腔镜直肠癌根治术中采用“四步法”清扫No.253淋巴结能有效缩短手术时间,具有与传统方法近似的淋巴结清扫效果及预后,且不增加术后并发症的发生,安全可行。
Objective To explore the application effect of"four-step"dissection of lymph node No.253 in radical resection of rectal cancer with left colic artery(LCA)preserved.Methods A total of 90 patientswho received laparoscopic radical resection for rectal cancer from January 2020 to May 2021 were retrospectively selected and divided into two groups according to digital table method,with 45 cases in each group.Low ligation of inferior mesenteric artery(IMA)to retain LCA and No.253 lymph node dissection were performed during the operation.The control group was cleaned by traditional method,and the observation group was cleaned by"four-step method".SPSS 19.0 software was used to analyze the data.Perioperative relevant indicators,No.253 lymph node dissection and other indicators were expressed by(x±s),and independent sample t test was performed.The occurrence of complications was represented by[cases(%)],and x^(2) tests were performed.Survival was analyzed by Kaplan-Meier method and Log-Rank test was performed.P<0.05 was considered statistically significant.ResultsThe operation time of observation group was shorter than that of control group(P<0.05).There were no significant differences in other perioperative indicators,lymph node dissection,postoperative complication rate,postoperative recurrence rate,metastasis rate and cumulative 3-year overall survival rate between 2 groups(P>0.05).Conclusion"Four-step"lymph node dissection for No.253 in laparoscopic radical resection of rectal cancer with LCA preservation can effectively shorten the operation time,has similar lymph node dissection effect and prognosis with traditional methods,and does not increase the occurrence of postoperative complications,so it is safe and feasible.
作者
郭倩
张晓峰
张鹏
苏文博
Guo Qian;Zhang Xiaofeng;Zhang Peng;Su Wenbo(Department of Gastrointestinal Surgery,Linfen People's Hospital,Linfen Shaanxi Province 041000,China)
出处
《中华普外科手术学杂志（电子版）》
2024年第4期411-414,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
山西省卫生健康委项目(2021159)。
关键词
直肠肿瘤
腹腔镜
大左结肠动脉
淋巴结切除术
手术后并发症
Rectal Neoplasms
Laparoscopes
Left Colic Artery:Lymph Node Excision
Postoperative Complications
