摘要
目的 探讨保留左结肠动脉(LCA)腹腔镜全直肠系膜切除术(TME)治疗中低位直肠癌的可行性及安全性。方法 选取2019年1月至2022年1月我院收治的98例经腹腔镜TME治疗的中低位直肠癌患者为研究对象,以治疗方案差异将其分为对照组(49例,不保留LCA腹腔镜TME)和研究组(49例,保留LCA腹腔镜TME)。比较两组的治疗效果。结果 两组的术中出血量、淋巴结清扫数目、吻合口距肛缘距离比较,差异无统计学意义(P>0.05);研究组的边缘动脉弓压力低于对照组,术后通气时间、住院时间短于对照组(P<0.05)。术后3 d,两组的胃动素、胃泌素水平及肛管静息压、肛管最大收缩压低于术前,直肠最大耐受容量小于术前(P<0.05);术后3 d,研究组的胃动素、胃泌素水平及肛管静息压、肛管最大收缩压高于对照组,直肠最大耐受容量大于对照组(P<0.05)。术后3 d,两组的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)及白细胞介素-1β(IL-1β)水平高于术前,但研究组低于对照组(P<0.05)。研究组的并发症总发生率低于对照组(P<0.05)。结论 保留LCA腹腔镜TME治疗中低位直肠癌的效果显著,对患者胃肠动力与肛门功能的影响小,机体产生的炎性反应轻,且患者预后恢复理想,具有较高的应用价值。
Objective To investigate the feasibility and safety of laparoscopic total mesorectal excision(TME)with preservation of left colic artery(LCA)in the treatment of middle and low rectal cancer.Methods A total of 98 patients with middle and low rectal cancer treated by laparoscopic TME in our hospital from January 2019 to January 2022 were selected as the research objects.According to the difference of treatment plan,the patients were divided into control group(49 cases,laparoscopic TME without preservation of LCA)and study group(49 cases,laparoscopic TME with preservation of LCA).The therapeutic effects of the two groups were compared.Results There were no significant differences in intraoperative blood loss,number of lymph node dissection and distance from anastomosis to anal margin between the two groups(P>0.05);the marginal aortic arch pressure of the study group was lower than that of the control group,and the postoperative ventilation time and hospitalization time were shorter than those of the control group(P<0.05).At 3 d after operation,the levels of motilin,gastrin,anal resting pressure and anal maximum systolic pressure in the two groups were lower than those before operation,and the maximum tolerable volume of rectum was smaller than that before operation(P<0.05);at 3 d after operation,the levels of motilin,gastrin,anal resting pressure and anal maximum systolic pressure in the study group were higher than those in the control group,and the maximum tolerable volume of rectum was greater than that in the control group(P<0.05).At 3 d after operation,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)and interleukin-1β(IL-1β)in the two groups were higher than those before operation,but those in the study group were lower than the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion The laparoscopic TME with preservation of LCA in the treatment of middle and low rectal cancer has signif
作者
吴瑞卿
WU Ruiqing(Jiaozuo People's Hospital,Jiaozuo 454000,China)
出处
《临床医学研究与实践》
2024年第28期59-62,共4页
Clinical Research and Practice
关键词
直肠癌
左结肠动脉
腹腔镜
全直肠系膜切除术
rectal cancer
left colic artery
laparoscope
total mesorectal excision
