临床普外科电子杂志 ›› 2024, Vol. 12 ›› Issue (1): 41-.

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保留左结肠动脉腹腔镜直肠癌根治术对患者胃功能、并发症的影响

  

  1. 敦化市医院 普通外科,吉林 敦化 133700
  • 出版日期:2024-01-01 发布日期:2024-04-16

The impact of laparoscopic radical resection of rectal cancer with preservation of left colic artery on gastric function and complications in patients

  1. General Surgery Department of Dunhua Hospital, Jilin Dunhua 133700, China
  • Online:2024-01-01 Published:2024-04-16

摘要:

目的 探析保留左结肠动脉(left colic artery,LCA) 腹腔镜直肠癌根治术对患者胃功能、并发症的影响。方法 选取2020 年12 月至2023 年11 月敦化市医院收治的57 例行腹腔镜直肠癌根治术患者,按随机数字分组法分为对照组(28 例) 与观察组(29 例)。对照组患者术中不保留LCA,观察组术中保留LCA。对比两组并发症发生率、胃功能、排尿功能、肛肠动力学。结果 与术前比,术后30d 两组患者的胃泌素、胃动素、胃蛋白酶原Ⅰ、降钙素基因相关肽(calcitonin gene-related peptide,CGRP) 水平均升高,且观察组患者的胃泌素、胃动素、胃蛋白酶原Ⅰ、CGRP 水平高于对照组;与术前相比,术后30d 两组患者的肛管静息压、肛管最大收缩压均降低,且观察组患者的肛管静息压、肛管最大收缩压均高于对照组,差异均有显著性(P < 0.05)。术后7d 两组患者的膀胱过度活动症状评分(overactive bladder symptom scale,OABSS) 各项评分较术前均降低,且术后7d 观察组患者的OABSS 各项评分低于对照组,差异均有显著性(P < 0.05)。观察组患者术后并发症总发生率低于对照组,差异有显著性(P < 0.05)。结论 腹腔镜根治术中保留LCA 可改善直肠癌患者的肛肠动力学指标,快速恢复其胃功能与排尿功能,并降低并发症发生风险。

关键词: 左结肠动脉, 腹腔镜直肠癌根治术, 胃功能, 并发症

Abstract:

Objective To explore the effects of preserving the left colic artery (LCA) in laparoscopic radical resection of rectal cancer on gastric function and complications in patients. Method 57 patients who underwent laparoscopic radical resection of rectal cancer admitted to Dunhua Hospital from December 2020 to November 2023 were randomly divided into a control group (28 cases) and an observation group (29 cases). The control group did not retain LCA during surgery, while the observation group retained LCA during surgery. Compare the incidence of complications, gastric function, urinary function, and anorectal dynamics between two groups. Result Compared with preoperative, the levels of gastrin, motilin, pepsinogen Ⅰ , and calcitonin gene related peptide

(CGRP) in both groups of patients increased 30 days after surgery, and the levels of gastrin, motilin, pepsinogen Ⅰ , and CGRP in the observation group were higher than those in the control group. Compared with preoperative data, the resting pressure and maximum systolic pressure of the anal canal in both groups of patients decreased 30 days after surgery, and the resting pressure and maximum systolic pressure of the anal canal in the observation group were higher than those in the control group, with significant differences (P < 0.05). On the 7th day after surgery, the overactive bladder symptom scale (OABSS) scores of both groups of patients decreased compared to before surgery, and the OABSS scores of the observation group were lower than those of the control group, with significant differences (P < 0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group, with a significant difference (P < 0.05). Conclusion Preserving LCA during laparoscopic radical surgery can improve the anorectal motility indicators of rectal cancer patients, quickly restore their gastric and urinary functions, and reduce the risk of complications.

Key words: Left colic artery, Laparoscopic radical resection of rectal cancer, Gastric function, Complications