| Objective:To investigate whether the left colonic artery is preserved in laparoscopic radical resection of rectal cancer.Methods : From January 2012 to June 2018,the clinical data of 120 patients with primary rectal cancer treated by the same group of physicians in gastrointestinal surgery of Bozhou people’s Hospital and laparoscopic radical resection of rectal cancer were analyzed retrospectively.The patients were divided into two groups:the non reserved group and the reserved group,both of which were 60 cases.The left colon artery was not reserved in the non reserved group,while the left colon artery was reserved in the reserved group.The perioperative clinical indexes,postoperative pathological indexes and postoperative follow-up of the two groups were observed Results comparison,postoperative recovery index comparison,gastrointestinal function comparison.Results SPSS 25.0 statistical software was used to analyze the difference.P<0.05,It was considered that there was statistical significance in the difference.Results : The operation time and intraoperative hemorrhage in the left colon artery group were(143.22±15.63)min,(70.86±7.59)ml,respectively,while those in the left colon artery group were(144.90±14.87)min,(73.10±6.65)ml,respectively,with no significant difference between the two groups(P > 0.05)There were 3 cases of anastomotic leakage after operation without left colonic artery reservation and no anastomotic leakage after operation in the left colonic artery reservation group,but there was no significant difference between the two groups(P > 0.05);there was no need for free colonic splenic flexure and preventive terminal ileostomy in the reservation group,and 5 cases of anastomotic dilation caused by sigmoidostomy and distal colonic ischemia and cyanosis in the reservation group The difference between the two groups was statistically significant(P < 0.05)in order to prevent intestinal ischemic necrosis and free colonic and splenic flexure.In addition,six cases were treated with terminal ileostomy due to suspected blood circulation disorder of anastomotic stoma.The difference between the two groups was statistically significant(P < 0.05)There was no significant difference in TNM stage and other postoperative pathological indexes(P >0.05);after 36 months of follow-up,it was found that there were 2 cases of local recurrence(3.33%),5 cases of distant metastasis(8.33%),2 cases of local recurrence(3.33%)and 3 cases of distant metastasis(5.00%)in the retention group,although the distant metastasis rate in the retention group was slightly lower than that in the retention group,there was no significant difference between the two groups Significance(P >0.05);postoperative retention of patients * urinary retention,sexual dysfunction,defecation frequency and anastomotic leakage rate were 96.67%,significantly better than that of non retaining group 80%,the difference was statistically significant(P<0.05);postoperative retention of gastrointestinal drainage volume,initial anal exhaust time,initial self defecation time and bowel sounds recovery time,etc.The functional indexes were(621.23±33.94)ml / d,(14.30±3.93)h,(2.23±0.57)d,(2.17±0.90)d,which were significantly better than those of the unreserved group(543.91±32.44)ml / d,(22.51±3.62)h,(3.55±0.90)d,(3.33±1.26)d(P < 0.05).Conclusion:In laparoscopic surgery for rectal cancer,preserving the left colon artery can effectively ensure the wound healing and prevent other complications.At the same time,it has great value in improving gastrointestinal function.After the clinical control study,there are few other adverse symptoms.Generally speaking,it is a safe and reliable treatment for patients,which provides the possibility for the development of future medical surgery and is worth promoting. |
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