Evaluation Of Left Colon Artery Preservation In Laparoscopic Radical Resection Of Rectal Cancer

Objective: To investigate the short-term clinical effect of preserving left colon artery(LCA)and not preserving left colon artery in laparoscopic radical resection of rectal cancer.Methods: The retrospective analysis method was used to collect the clinical data of 89 patients undergoing laparoscopic radical rectal cancer resection admitted to the Department of General Surgery of our hospital from June 2020 to June 2022,and divided into the group without left colonic artery preservation(n=46)and the left colonic artery preservation group(n=43)according to whether the left colonic artery was preserved.The retention group ligates below the left colonic artery branch from the inferior mesenteric artery,that is,the left colonic artery branch is preserved;The unreserved group ligated the artery at the beginning of the inferior mesenteric artery,did not preserve the left colonic artery;The baseline data,postoperative complications,operation time,intraoperative blood loss,total lymph node dissection,number of lymph node dissection in 253 groups,postoperative complications,first postoperative exhaust time,postoperative hospital stay,free colonic splenic area,number of protective stomastomy,recurrence and metastasis were compared between the retention group and the non-retention group.Results:1.Baseline data: There was no significant difference in the data of the two groups in terms of age,sex,TNM stage,tumor distance from the margin,BMI,etc.,and were comparable.2.Perioperative period: both groups successfully completed the operation,the intraoperative blood loss in the retention group was(88.32±25.06)ml,and the intraoperative blood loss in the non-retention group was(96.96±27.15)ml,and the difference between the two groups was not statistically significant(P>0.05);The operation time of the retention group was(251.16±41.87)min,and the operation time of the non-retention group was(231.41±46.05)min,and the difference between the two groups was statistically significant(P<0.05).The total number of lymph node dissections in the retention group(12.95±3.63),the number of lymph node dissections in 253 groups(3.12±1.07),the total lymph node dissection in the non-retention group(13.37±5.63),and the number of lymph node dissections in 253 groups(3.41±0.96),there was no significant difference between the two groups(P>0.05).There were no significant differences between the data such as time to first postoperative exhaust,length of hospital stay,free colonic and splenic area,and protective stoma,(P>0.05).In terms of short-term complications,0 cases of anastomotic leakage,2 cases of incision infection,and 1 case of intestinal obstruction occurred in the retention group.In the non-reserved group,6 cases of anastomotic leakage,3 cases of incision infection and 2cases of intestinal obstruction were statistically different between the overall short-term complications data(P<0.05),and the comparison between anastomotic leakage data was statistically significant(P<0.05).In terms of complications related to pelvic organ dysfunction,urinary retention occurred in 1 case and defecation incontinence in the retention group in 1 case,urinary retention in the retention group in 2 cases and defecation incontinence in 5 cases,and there were no significant differences between the data(P>0.05).3.Patients in the two groups were followed up for 6-30 months,among which the number of cases of local recurrence in the control group was 1,the number of cases of distant metastasis was 1,the number of cases of local recurrence in the observation group was 2cases,and the number of cases of distant metastasis was 4cases,and there was no significant difference between the data between the two groups(P>0.05)Conclusion:Preservation of the left colon artery in laparoscopic rectal cancer surgery can reduce the incidence of anastomotic leakage in patients,and the overall short-term complication rate has also decreased,which can achieve the same effective lymph node dissection and prognosis as high ligation,although its operation time is longer than that of the left colon artery,but it will not affect the recovery time of patients after surgery,and the protective effect on pelvic organ function is the same as that of high ligation.The effect of preserving the left colonic artery during surgery is positive and can be further promoted.