保留左结肠动脉的乙状结肠癌根治术的疗效分析

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1、直代临床外科2014年2月第14卷第1期LingnanModemclinicsinSurry．Feb．2014．V01．14N0．137保留左结肠动脉的乙状结肠癌根治术的疗效分析吕益中朱劲涛谭明华蒋新权【摘要】目的探讨保留左结肠动脉(LCA)的乙状结肠癌根治术的术式安全性和可行性。方法回顾性分析2010年4月至2013年5月开腹下行保LCA的乙状结肠癌根治术手术(=32，LCA保留组)，采用历史对照的方法，评估保LCA组和肠系膜下动脉根部结扎的传统乙状结肠癌根治术(n=43，传统组)两组患者的手术效果、临床病理资料以

2、及术后并发症。结果保LCA组和传统手术组的平均手术时间和出血量亦未见明显差异。但LCA组与传统手术组相比，切除的近端肠管(11．5cmvs16．7cm)和远端肠管(5．8emvs8．7cm)长度更短，差异具有显著的统计学差异(P<0．05)。LCA组并不减少术后活检淋巴结的个数，亦未见主淋巴结群活检的淋巴结个数(2．3枚VS2．1枚)及阳性淋巴结个数(0．2枚VS0．3枚)减少。两组患者术后并发症的比较并无明显的差别。结论保LCA的乙状结肠癌根治术治疗乙状结肠癌是可行、安全、有效的，可保证肠系膜下动脉根部淋巴结的根治

3、性，并不增加手术的风险。【关键词】左结肠动脉；肠系膜下动脉；乙状结肠癌中图分类号：R656．9文献标识码：A文章编号：1009—976X(2014)01—0037—04doi：10．3969／j．issn．1009—976X．2014．01．011EfectonthepreservationofleftcolicarteryinsigmoidcoloncancerradicalresectionLvYizhong，ZhuJingtoo，TanMinghua，JiangXinquan．DepartmentofGener

4、alSurgery，ChanchengDistrictCentralHospital，Foshan，Guangdong528091，Chinc~Correspondingauthor：cczxyylyz@sina．cn【Abstract】ObjectiveToexploretheeffectandsafetyofpreservationoftheleftcolicartery(LCA)forthetreatmentofsigmoidcoloncancer．MethodsAtotalof75caseswithsigmo

5、idcoloncancerwereincludedinthestudyandtheclinicaldatawereanalyzedretrospectively．Of75cases，32underwentradicaldissectionwithLCApreservation(LCApreservationgroup)，theoneswhounderwenttraditionalsurgerywithcuttingtherootofinferiormesentericarterywerecontrols．Thesur

6、gicaleffect，clinicalpathologicalparametersandpostoperativecomplicationswerecomparedbetweentwogroups．ResultsTherewerenodifferencesinsurgicaltimeandbloodlossbetweenLCApreservationgroupandtraditionalgroup．Theproximalbowelcutend(11．5cmVS16．7cm)anddistalbowelcutend(

7、5．8cmVS8．7am)werebothshorterintheLCApreservationgroup．Wefoundnodifferenceintheamountofpostoperativeharvestedlymphnodes．Themaingroupofharvestedlymphnodes(2．3VS2．1)andpositivelymphnodes(0．2VS0．3)weresimilarbetweentwogroups．Wealsofoundthattheincidencesofoverallcom

8、plicationsweresimilarbetweenLCApreservationgroupandtraditionalgroup．ConclusionTheapplicationofLCApreservationforthetreatmentofsigmoidcoloncancerwasavailable，safeandeffective