摘要【目的】探讨腹腔镜直肠癌前切除术中低位结扎肠系膜下动脉(IMA)时保留左结肠动脉(LCA)的临床疗效。【方法】回顾性分析2014年6月至2017年12月本院收治的122例行腹腔镜直肠癌前切除术患者的病例资料,其中保留左结肠动脉56例(低位结扎组),不保留左结肠动脉66例(高位结扎组)。观察记录两组手术时间、术中出血量、肠系膜血管根部淋巴结清扫数、淋巴结阳性率、术后恢复排气时间、住院天数、吻合口瘘发生情况。【结果】两组患者均顺利完成腹腔镜手术,无中转开腹,术中术后无死亡病例,并未出现严重并发症。低位结扎组与高位结扎组手术时间[(117.6±16.5)min vs(95.2.6±18.4)min]、术后吻合口瘘发生率(0 vs 6.1%)比较,差异有统计学意义(均P<0.05)。两组术中出血量、清扫肠系膜下血管根部淋巴结数量、淋巴结阳性率、术后恢复排气时间及住院天数方面比较,差异无统计学意义(均P>0.05)。【结论】保留左结肠动脉在腹腔镜直肠癌前切除术中能为结肠吻合口血运提供更好的保障,并可以完成同样彻底的淋巴结清扫,其有临床推广价值。
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2018, Vol. 35 
