WU Jianbo, SHI Jun, ZHU Qiuwei, CAO Xiang, GENG Xiang, REN Jun, GONG Yu, ZHU Ping. Benefit analysis of preservation of left colonic artery in laparoscopic radical resection of rectal cancer in elderly patients[J]. Journal of Clinical Medicine in Practice, 2020, 24(11): 114-117. DOI: 10.7619/jcmp.202011031
Citation: WU Jianbo, SHI Jun, ZHU Qiuwei, CAO Xiang, GENG Xiang, REN Jun, GONG Yu, ZHU Ping. Benefit analysis of preservation of left colonic artery in laparoscopic radical resection of rectal cancer in elderly patients[J]. Journal of Clinical Medicine in Practice, 2020, 24(11): 114-117. DOI: 10.7619/jcmp.202011031

Benefit analysis of preservation of left colonic artery in laparoscopic radical resection of rectal cancer in elderly patients

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  • Received Date: April 02, 2020
  • Available Online: August 27, 2020
  • Objective To evaluate the clinical significance of preservation of the left colonic artery(LCA)in laparoscopic radical resection of rectal cancer in elderly patients. Methods Clinical data of 204 rectal cancer patients undergoing laparoscopic radical resection was retrospectively analyzed, 98 cases with preservation of LCA were selected as preservation group and 106 cases without preservation of LCA were included in non-preservation group. Operation-related conditions were compared between the two groups. Results Operation time was significantly longer in the preservation group than that in the non-preservation group [(121.41±14.02)min vs.(109.74±12.92)min, P<0.01]. The cololysis of splenic flexure in the preservation group was significantly higher than that in the non-preservation group(P<0.05). The preservation group underwent no preventive terminal ileum stoma, and 6 cases in the non-preservation group received preventive terminal ileum stoma, a significant difference was found in two groups(P<0.05). No significant differences in terms of total number of lymph node dissection and the number of lymph node(No.253)dissection, intraoperative blood loss, postoperative exhaust time, proximal colonic ischemia, anastomotic bleeding, anastomosis leakage were found between the two groups(P>0.05). Conclusion Preservation of the left colonic artery in laparoscopic radical resection of rectal cancer in elderly patients can reduce preventive terminal ileum stoma, conform to the requirement of radical clearance of lymph nodes, and it is safe and feasible in technology.
  • 沈荐, 李敏哲, 杜燕夫, 等. 腹腔镜直肠癌前切除术中保留左结肠动脉与否的临床对照研究[J]. 中国微创外科杂志, 2014, 14(1): 22-24.
    祝林, 刘志民, 徐其佐, 等. 保留左结肠动脉的腹腔镜直肠癌前切除术的临床体会[J]. 腹腔镜外科杂志, 2014, 19(3): 185-186.
    冯波, 郑民华, 毛志海, 等. 70岁以上老年人腹腔镜结直肠癌手术的安全性[J]. 中华老年医学杂志, 2006, 25(2): 113-116.
    牛晋卫, 宁武, 王文跃, 等. 保留左结肠动脉在腹腔镜下直肠癌前切除术后的临床作用[J]. 中华医学杂志, 2016, 96(44): 3582-3585.
    程邦昌, 昌盛, 黄杰, 等. 结肠代食管术中结肠血管结构的研究[J]. 中华医学杂志, 2006, 86(21): 1453-1456.
    崔念磊. 保留左结肠动脉和直肠上动脉的上段直肠癌手术疗效分析[J]. 外科研究与新技术, 2014, 13(3): 177-179.
    池畔, 官国先. 腹腔镜直肠系膜全切除术难点和争议[J]. 中华腔镜外科杂志: 电子版, 2012, 5(1): 5-8.
    Sekimoto M, Takemasa I, Mizushima T, et al. Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery[J]. Surg Endosc, 2011, 25(3): 861-866.
    伍锦浩, 戎祯祥, 朱达坚, 等. 保留左结肠动脉的腹腔镜直肠癌前切除低位吻合术[J]. 南方医科大学学报, 2009, 29(6): 1249-1250.
    谢泽民, 章社民. 保留左结肠动脉的腹腔镜直肠癌前切除术的临床疗效[J]. 中国临床保健杂志, 2015, 18(2): 202-204.
    Buunen M, Lange M M, Ditzel M, et al. Level of arterial ligation in total mesorectal excision(TME): an anatomical study[J]. Int J Colorectal Dis, 2009, 24(11): 1317-1320.
    Bonnet S, Berger A, Hentati N, et al. High Tie versus low Tie vascular ligation of the inferior mesenteric artery in colorectal cancer surgery: impact on the gain in colon length and implications on the feasibility of anastomoses[J]. Dis Colon Rectum, 2012, 55(5): 515-521.
    Meyers M A. Griffiths' point: critical anastomosis at the splenic flexure. Significance in ischemia of the colon[J]. AJR Am J Roentgenol, 1976, 126(1): 77-94.
    Lange J F, Komen N, Akkerman G, et al. Riolan's arch: confusing, misnomer, and obsolete. A literature survey of the connection(s)between the superior and inferior mesenteric arteries[J]. Am J Surg, 2007, 193(6): 742-748.
    苗登顺, 时长军. 结肠边缘动脉的应用解剖[J]. 苏州大学学报: 医学版, 1988, 8(4): 279-281.
    杜燕夫, 渠浩. 肠系膜下动脉不同的分支和变异在直肠癌根治术中的临床意义[J]. 中华结直肠疾病电子杂志, 2015, 4(5): 474-477.
    Corder A P, Karanjia N D, Williams J D, et al. Flush aortic Tie versus selective preservation of the ascending left colic artery in low anterior resection for rectal carcinoma[J]. Br J Surg, 1992, 79(7): 680-682.
    Komen N, Slieker J, de Kort P, et al. High Tie versus low Tie in rectal surgery: comparison of anastomotic perfusion[J]. Int J Colorectal Dis, 2011, 26(8): 1075-1078.
    Birgisson H, Påhlman L, Gunnarsson U, et al. Adverse effects of preoperative radiation therapy for rectal cancer: long-term follow-up of the Swedish Rectal Cancer Trial[J]. J Clin Oncol, 2005, 23(34): 8697-8705.
    曾海敬, 吴祖光. 保留左结肠动脉(升支)的腹腔镜直肠癌全切除术的疗效观察[J]. 外科研究, 2017, 7(2): 162-165.
    Hinoi T, Okajima M, Shimomura M, et al. Effect of left colonic artery preservation on anastomotic leakage in laparoscopic anterior resection for middle and low rectal cancer[J]. World J Surg, 2013, 37(12): 2935-2943.
    Leichtle S W, Mouawad N J, Welch K B, et al. Risk factors for anastomotic leakage after colectomy[J]. Dis Colon Rectum, 2012, 55(5): 569-575.
    陈进, 邱明远, 蒋恺, 等. 预防性回肠造瘘在70岁及以上老年低位直肠癌保肛术中的应用[J]. 中华老年医学杂志, 2014, 33(8): 905-906.
    郑跃东. 老年低位直肠癌全系膜切除预防性回肠造瘘应用[J]. 国际医药卫生导报, 2013, 19(5): 670-672.
    高利珍, 刘筠, 李鹏, 等. 吻合口位置及预防性回肠造瘘对直肠癌术后吻合口瘘的影响[J]. 中华普通外科杂志, 2016, 31(12): 1015-1017.
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