保留直肠上动脉和左结肠动脉的腹腔镜根治术治疗乙状结肠癌的临床疗效
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摘要
目的:观察保留直肠上动脉和左结肠动脉的腹腔镜根治术治疗乙状结肠癌的临床疗效。方法:回顾性分析本院2014年8月至2016年5月的92例行腹腔镜乙状结肠癌根治术患者的临床资料,按手术方法的不同将其分为对照组43例和研究组49例。对照组为常规腹腔镜乙状结肠癌根治术治疗,研究组为保留直肠上动脉和左结肠动脉的腹腔镜乙状结肠癌根治术。比较两组患者术中情况(淋巴结清扫数量、术中失血量和手术时间)及术后情况(切口愈合时间、住院时间、并发症发生率及复发率)。结果:两组淋巴结清扫数量对比,差异无统计学意义(P>0.05)。研究组术中失血量明显少于对照组,手术时间明显长于对照组,住院时间明显短于对照组,差异均有统计学意义(P<0.05);研究组并发症发生率为4.1%,明显低于对照组的18.6%,差异有统计学意义(P<0.05);研究组复发率为12.2%,低于对照组的27.9%,但差异无统计学意义(P>0.05)。结论:保留直肠上动脉和左结肠动脉的腹腔镜根治术治疗乙状结肠癌的临床疗效优于常规腹腔镜乙状结肠癌根治术。
Objective: To study effects of laparoscopic radical surgery for sigmoid colon cancer with preservation of superior rectal and left colic arteries. Methods: The clinical data of 92 patients undergone the laparoscopic radical surgery for sigmoid colon cancer from August 2014 to May 2016 were retrospectively analyzed. According to the different treatment methods, they were divided into control group(n=43) and study group(n=49). The control group was treated with the conventional laparoscopic radical surgery for sigmoid colon cancer, while the study group underwent the laparoscopic radical surgery for sigmoid colon cancer with preservation of the superior rectal and left colon arteries. The intraoperative situations(number of lymph node dissection, intraoperative blood loss and operation time) and postoperative conditions(incision healing time, hospitalization time, complication rate and recurrence rate) were compared between the two groups. Results: There was no significant difference in the number of lymph node dissection between the two groups(P>0.05). The intraoperative blood loss of the study group was significantly less than that of the control group; the operation time was significantly longer than that of the control group; the hospitalization time was significantly shorter than that of the control group; and the differences were statistically significant(P<0.05). The complication rate of the study group was 4.1%, which was significantly lower than that of the control group(18.6%), and the difference was statistically significant(P<0.05). The recurrence rate of the study group was 12.2%, which was lower than that of the control group(27.9%), but the difference was not statistically significant(P>0.05). Conclusions:Laparoscopic radical surgery for sigmoid colon cancer with preservation of superior rectal and left colic arteries is superior to conventional laparoscopic radical surgery.
Objective: To study effects of laparoscopic radical surgery for sigmoid colon cancer with preservation of superior rectal and left colic arteries. Methods: The clinical data of 92 patients undergone the laparoscopic radical surgery for sigmoid colon cancer from August 2014 to May 2016 were retrospectively analyzed. According to the different treatment methods, they were divided into control group(n=43) and study group(n=49). The control group was treated with the conventional laparoscopic radical surgery for sigmoid colon cancer, while the study group underwent the laparoscopic radical surgery for sigmoid colon cancer with preservation of the superior rectal and left colon arteries. The intraoperative situations(number of lymph node dissection, intraoperative blood loss and operation time) and postoperative conditions(incision healing time, hospitalization time, complication rate and recurrence rate) were compared between the two groups. Results: There was no significant difference in the number of lymph node dissection between the two groups(P>0.05). The intraoperative blood loss of the study group was significantly less than that of the control group; the operation time was significantly longer than that of the control group; the hospitalization time was significantly shorter than that of the control group; and the differences were statistically significant(P<0.05). The complication rate of the study group was 4.1%, which was significantly lower than that of the control group(18.6%), and the difference was statistically significant(P<0.05). The recurrence rate of the study group was 12.2%, which was lower than that of the control group(27.9%), but the difference was not statistically significant(P>0.05). Conclusions:Laparoscopic radical surgery for sigmoid colon cancer with preservation of superior rectal and left colic arteries is superior to conventional laparoscopic radical surgery.
引文
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[2]聂辉.两种肠造口术在治疗老年梗阻性乙状结肠癌和高位直肠癌中的应用价值分析[J].基层医学论坛,2017,10(16):2074-2075.
[3]朱健伟.肠系膜下动脉结扎方式对乙状结肠癌及直肠癌生存预后的Meta分析[J].中国现代普通外科进展,2017,20(12):940-943.
[4]张云,龚航军,韩刚,等.腹腔镜保留直肠上动脉的D3淋巴结清扫术在降结肠、近段乙状结肠癌根治术中的临床应用[J].腹腔镜外科杂志,2017,22(3):180-184.
[5]Krarup PM,Jorgensen LN,Harling H.Management of anastomotic leakage in a nationwide cohort of colonic cancer patients[J].J Am Coll Surg,2014,218(5):940-949.
[6]詹承吉,周东明,徐朝晖.乙状结肠癌根治术中保留左结肠动脉的疗效及可行性分析[J].浙江临床医学,2017,19(8):1497-1498.
[7]卢杏生,徐勇,秦安成.回肠袢式造口术对梗阻性直乙状结肠癌患者生活质量影响及安全性分析[J].河北医药,2016,38(7):1001-1003.
[8]谢锷,王小忠,黄耀奎.腹腔镜辅助乙状结肠癌根治术中两种不同术式效果的比较[J].广东医学,2017,38(8):1220-1221.
[9]何盟国,沈乃营,郑康,等.腹腔镜结肠癌根治术对I、II期结肠癌患者近期复发的影响[J].腹腔镜外科杂志,2016,21(7):523-528.
[10]汤小龙,曲辉,何庆泗,等.保留左结肠动脉及直肠上动脉的腹腔镜乙状结肠癌根治术的临床应用及近期疗效分析[J].腹腔镜外科杂志,2017,22(12):903-906.