南方医科大学学报2017，Vol.37Issue(9)：1261-1264,4.DOI:10.3969/j.issn.1673-4254.2017.09.21
腹腔镜下直肠前切除术中保留左结肠动脉对促进患者术后的康复作用
Enhanced recovery after preserving the left colonic artery during laparoscopic anterior resection for rectal cancer
摘要
Abstract
Objective To evaluate the postoperative outcomes of preserving the left colonic artery during laparoscopic anterior resection for rectal cancer.Methods The clinicopathologic data of 91 rectal cancer patients (pathologic Stage Ⅱ) undergoing laparoscopic anterior resection was retrospectively analyzed.During the surgeries,the left colonic artery was preserved in 40 patients (preserved group) and ligated in 51 patients (unpreserved group).The operating time,intraoperative blood loss,time to first flatus and defecation,duration of postoperative abdominal distension and pain,number of retrieved lymph nodes,ileum fistulation and anatomical leakage rate were compared between the two groups.Results The surgeries were completed in all the 91 patients laparoscopically without conversion.There was no intraoperative complications including rectal perforation,injury to vessel or ureter in either group.The operating time,blood loss and number of retrieved lymph nodes were similar between the groups (P＞0.05).Three patients in preserved group and 5 in ligation group received preventive ileum fistulation due to low rectal cancer.Anatomical leakage occurred in three patients of unpreserved group.The average duration of postoperative abdominal distension and pain was 2.14±0.35 days in preserved group and 3.15±0.42 days in ligation group.The time to first flatus and defecation was 37.15±12.62 h and 3.16±0.52 days in preserved group and 62.25±11.75 h and 4.25±0.75 days in ligation group.Postoperative hospital stay was 4.54±0.42 days in preserved group and 6.23±0.51 days in ligation group.Total hospitalization cost in the two groups was 34 525.32±1206.36 Yuan and 41 215±1051.32 Yuan,respectively.Significant differences were found the in duration of postoperative abdominal distension and pain,postoperative hospital stay,and total cost between the two groups (P＜0.05).Conclusion During laparoscopic anterior resection for rectal cancer,preserving the left colonic artery effectively ensures the blood supply to the anastomosis and the remaining descending colon to promote the recovery of the patients after surgery.关键词
腹腔镜/直肠癌前切除术/快速康复/左结肠动脉Key words
laparoscopy/anterior resection/enhanced recovery after surgery/left colonic artery引用本文复制引用
刘云庚,张磊,黄箕然,易金容,方传发,夏来阳,刘红权,易建中..腹腔镜下直肠前切除术中保留左结肠动脉对促进患者术后的康复作用[J].南方医科大学学报,2017,37(9):1261-1264,4.基金项目
赣州市指导性科技计划项目(GZ2015ZSF195) （GZ2015ZSF195）
