摘要
目的:探讨直肠全系膜切除术(total mesorectal excision,TME)联合保留左结肠动脉术(left colonic artery,LCA)对直肠癌患者疗效及对淋巴结转移率、尿潴留发生率的关系。方法:选取我院于2017年1月至2019年3月诊断的100例直肠癌患者作为研究对象,随机分为两组,分别为观察组和对照组,每组患者50例,对照组患者采取TME手术,观察组采取TME术联合保留LCA术。比较两组患者近期疗效,围手术期指标以及并发症。结果:两组患者的近期治疗效果之间的差异不存在统计学意义(P>0.05);两组患者的围手术期手术时间、术中出血量、排气时间、淋巴结清扫情况以及第三站淋巴结转移情况之间的差异不存在统计学意义(P>0.05);观察组患者的吻合口瘘情况和尿潴留情况显著低于对照组,差异存在统计学意义(P<0.05),ORR组患者的第三站淋巴结转移情况以及尿潴留情况低于非ORR组;疗效与淋巴结转移、尿潴留发生情况呈负相关。结论:直肠癌患者采用TME术联合保留LCA术治疗,吻合口瘘以及尿潴留情况显著改善,患者的淋巴结转移、尿潴留发生情况与疗效呈负相关,可作为临床效果评价指标之一。
Objective:To observe the effect of total mesorectal excision(TME)combined with left colonic artery(LCA)preservation on rectal cancer patients and its relationship with incidence of lymph node metastasis and complications.Methods:100 patients with rectal cancer diagnosed in our hospital from January 2017 to March 2019 were randomly divided into two groups,the observation group and the control group,with 50 cases in each group.The observation group was treated with TME,while the control group was treated with TME combined with LCA preservation.The short-term efficacy,perioperative indicators and complications of the two groups were compared.Results:There was no significant difference between the two groups in short-term therapeutic effect,perioperative operation time,intraoperative bleeding volume,exhaust time,lymph node dissection and lymph node metastasis in the third station(P>0.05).Incidences of anastomotic leakage and urinary retention in the observation group were significantly lower than those in the control group(P<0.05).The third station lymph node metastasis and urinary retention in ORR group were lower than those in non-ORR group.The curative effect was negatively correlated with lymph node metastasis and urinary retention.Conclusion:TME combined with LCA preservation for rectal cancer patients causes improvement in anastomotic leakage and urinary retention.The curative effect of TME combined with LCA preservation is negatively correlated with lymph node metastasis and urinary retention,and the latter two can be regarded as indicators of the former.
作者
罗水祥
蒋汉卿
陈健
陈波
张明敏
Luo Shuixiang;Jiang Hanqing;Chen Jian;Chen Bo;Zhang Mingmin(Department of General Surgery,Leshan Second People’s Hospital,Leshan 614000,Sichuan,China;Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)
出处
《肿瘤预防与治疗》
2020年第7期607-611,共5页
Journal of Cancer Control And Treatment
关键词
腹腔镜
直肠全系膜切除术
保留左结肠动脉
淋巴结转移率
Laparoscopy
Total mesorectal excision
Left colonic artery preservation
Lymph node metastasis
