岭南现代临床外科2025，Vol.25Issue(6)：375-381,7.DOI:10.3969/j.issn.1009-976X.2025.06.005
全直肠系膜切除术中保留LCA治疗中低位直肠癌的效果及并发症观察
Observation on effect and complications of LCA preservation during total mesorectal excision in the treatment of middle and low rectal cancer
摘要
Abstract
Objective To investigate the influence of presence or absence of preservation of left colonic artery(LCA)during laparoscopic total mesorectal excision(TME)on the therapeutic effect and complications in patients with middle and low rectal cancer.Methods Patients with middle and low rectal cancer who underwent TME in the hospital from January 2019 to December 2024 were selected.Accord-ing to different LCA treatment methods,they were divided into preservation group and non-preservation group.After excluding the influence of baseline data confounding factors by propensity score matching method,58 cases were finally obtained in preservation group and 53 cases in non-preservation group.The baseline data of the two groups after matching were balanced and comparable.The surgical indexes,complications,blood perfusion time,urination function,gastrointestinal function indexes and inflamma-tory factors were analyzed and compared between the two groups,and the prognosis of the two groups was followed up and counted.Results The first postoperative anal exhaust time,incidence rates of compli-cations and blood perfusion time after anastomosis in preservation group were shorter or lower than those in non-preservation group(P<0.05),while marginal arterial arch pressure was higher(P<0.05).At 1 month after surgery,the International Prostate Symptom Scale(IPSS)score was lower in preservation group than those in non-preservation group(P<0.05).At 3 days after surgery,the motilin and gastrin levels in preservation group were higher(P<0.05)while the levels of interleukin-1β(IL-1β),IL-6 and tumor necrosis factor-α were lower than those in non-preservation group(P<0.05).At 6-month follow-up,no deaths occurred in either group.There were no significant differences between groups in short-term complications,local recurrence rate and metastasis rate(P>0.05).Conclusion Preservation of LCA during laparoscopic TME for patients with middle and low rectal cancer is conducive to postoperative recovery,with low risk of perioperative complications and low incidence rate of postoperative urination disorders.关键词
全直肠系膜切除术/左结肠动脉/中低位直肠癌Key words
total mesorectal excision/left colonic artery/middle and low rectal cancer分类
医药卫生引用本文复制引用
曾岳岳,夏悦明,杨晓峰,吴淑桃,吴锦城,陈招武..全直肠系膜切除术中保留LCA治疗中低位直肠癌的效果及并发症观察[J].岭南现代临床外科,2025,25(6):375-381,7.基金项目
宁德市自然科学基金联合项目(2023J13) （2023J13）
