| Objective: To explore the short-term effect of preserving the left colon artery during laparoscopic radical resection of rectal cancer.Methods: A retrospective analysis of the clinical data of 117 patients who underwent laparoscopic radical resection of rectal cancer in Shengjing Hospital Affiliated to China Medical University from June 2018 to October 2020,according to the different ligation positions of the inferior mesenteric artery during the operation,The patients were divided into low ligation group(left colon artery reserved group,53 cases)and high ligation group(left colon artery group not reserved,64 cases),and statistics were based on the clinical data of the two groups before,during and after the operation Learn to compare and evaluate.Results: 1.Data with statistically significant differences: 4 cases of patients in the retention LCA group underwent protective ileostomy during the operation,the first postoperative time of exhaust was 2.33±0.41 days,and the first postoperative time of defecation was 3.52±0.75 days,the postoperative hospital stay was 8.43±1.72 days.There were 2 cases of postoperative complications: 2 cases of anastomotic leakage;15 cases of patients in the LCA group underwent protective ileostomy during operation,and the first postoperative exhaust time was 3.01±0.40 days,the first defecation time after surgery was 4.15±0.79 days,the length of postoperative hospital stay was 10.27±3.76 days,and there were 10 complications: postoperative bleeding in 1 case,rectovaginal fistula in 1 case,difficulty urinating in 2 cases,2 cases of incision infection and 4 cases of anastomotic leakage.There was a statistically significant difference between the two groups of patients in terms of whether to undergo a protective ileostomy during the operation,the time of first exhaust after the operation,the time of defecation,the length of postoperative hospital stay,and postoperative complications(P<0.05).2.Data without statistically significant differences: there were 53 cases in the reserved LCA group,including 32 male patients and 21 female patients.The average age of the patients was 63.49±7.86 years,the BMI was 23.25±2.39kg/m2,the operation time was 187.49±39.46 minutes,and the intraoperative blood loss was 62.43±11.81 ml,the total number of lymph node dissection is 12.30±5.18,22 patients with lymph node metastasis,1 case of local recurrence after operation,1 case of lung metastasis;64 cases of no LCA group,including 35 male patients and 29 female patients,average age of patients 61.45±11.22 years old,BMI23.28±2.92kg/m2,operation time 189.78±33.89 minutes,intraoperative blood loss 63.06±16.52 ml,total number of lymph node dissection 12.81±5.15,24 patients with lymph node metastasis,no local recurrence after operation,2 cases of lung metastasis,1 case of liver metastasis.The two groups of patients were in gender,age,BMI,TNM stage,distance from the tumor to the anus,maximum tumor diameter,preoperative CEA,preoperative CA199,ASA score,intraoperative blood loss,length of operation,number of lymph node metastases,and total number of lymph node dissections There were no significant differences in postoperative tumor recurrence and metastasis(P>0.05).Conclusion: Preserving the left colon artery during laparoscopic radical resection of rectal cancer can increase the blood supply of the anastomosis,and effectively clean 253 groups of lymph nodes,reduce the probability of intraoperative protective ileostomy,promote exhaust and defecation,and accelerate the recovery of intestinal function after surgery.Reduce the occurrence of postoperative complications,improve the prognosis,and significantly improve the quality of life of patients.The operation is safe and feasible,and it is worthy of promotion. |
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