摘要
目的探究全直肠系膜切除术(TME)联合保留左结肠动脉(LCA)术治疗直肠癌患者的临床疗效。方法回顾性分析2020年4月至2021年5月潜江市中心医院收治的97例直肠癌患者的临床资料,按照肠系膜下左结肠血管处理方式不同分为甲组(n=49)与乙组(n=48)。两组均实行TME术,甲组术中保留LCA,乙组术中不保留LCA,比较两组手术情况、术后恢复情况、尿流动力学指标、随访结果及并发症发生率。结果两组手术时间、出血量、淋巴清扫数比较差异无统计学意义;甲组首次排气、排便、拔除引流管时间及住院时间均短于乙组,差异有统计学意义(P<0.05);术后14d,两组最大尿流率(Qmax)均慢于术前,最大膀胱逼尿肌收缩压(MDP)低于术前,残余尿量(RUV)均高于术前,但甲组Qmax快于乙组,MDP高于乙组,RUV低于乙组,差异有统计学意义(P<0.05);两组复发率、肠系膜下动脉(IMA)根部淋巴结转移发生率比较差异无统计学意义;甲组并发症发生率为6.51%,低于乙组的21.74%,差异有统计学意义(P<0.05)。结论与TME术中不保留LCA比较,TME术中保留LCA治疗直肠癌效果确切,对患者膀胱功能的影响较小,可减少术后并发症的发生,促进术后恢复,且不会增加疾病复发及IMA根部淋巴结转移的发生。
Objective To explore the clinical efficacy of total mesorectal excision(TME)combined with left colon artery preservation(LCA)in the treatment of rectal cancer patients.Methods The clinical data of 97 patients with rectal cancer admitted to Qianjiang Central Hospital from April 2020 to May 2021 were retrospectively analyzed,they were divided into the group A(n=49)and the group B(n=48)according to different treatment methods of inferior mesenteric left colon vessels.TME was performed in both groups.LCA was retained in group A and LCA was not re-tained in group B,the operation,postoperative recovery,urodynamic indexes,follow-up results and complication rate were compared between the two groups.Results There was no significant difference in operation time,bleeding volume and number of lymph node dissection between the two groups;the first exhaust,defecation,drainage tube removal time and hospitalization time in the group A were shorter than those in the group B,the differences were statistically significant(P<0.05);at 14 d after operation,the maximum urinary flow rate(Qmax)of the two groups was slower than that before operation,the maximum detrusor muscle systolic pressure(MDP)was lower than that before operation,and the residual urine volume(RUV)was higher than that before operation,but the Qmax in the group A was faster than that in the group B,the MDP was higher than that in the group B,and the RUV was lower than that in the group B,the differences were statistically significant(P<0.05);there was no significant differ-ence in the recurrence rate and the incidence of lymph node metastasis at the root of inferior mesenteric artery(IMA)between the two groups;the incidence of complications in the group A was 6.51%,which was lower than 21.74%in the group B,the difference was statistically significant(P<0.05).Conclusion Compared with TME without LCA preservation,TME with LCA preservation is effective in the treatment of rectal cancer,which has little effect on the bladder function of patients,can reduce the occurrence o
作者
孙宇
朱云华
郝立政
SUN Yu;ZHU Yunhua;HAO Lizheng(Department of Gastrointestinal Surgery,Qianjiang Central Hospital,Qianjiang,Hubei,433100,China)
出处
《当代医学》
2024年第8期48-51,共4页
Contemporary Medicine
关键词
全直肠系膜切除术
保留左结肠动脉
直肠癌
并发症
Total mesorectal resection
Preserve the left colon artery
Rectal cancer
Complications
