Effect of retained the left colonic artery on gastrointestinal and anal function after laparoscopic D3 radical operation for rectal cancer
CHEN Dezhong CHANG Jian WANG Zhangyu
Department of General Surgery, Suzhou Jiulong Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Jiangsu Province, Suzhou 215000, China
Abstract：Objective To study the effect of retained the left colonic artery (LCA) on gastrointestinal and anal function after laparoscopic D3 radical operation for rectal cancer. Methods Eighty-five patients with rectal cancer admitted to Suzhou Jiulong Hospital Affiliated to Medical College of Shanghai Jiao Tong University from December 2016 to January 2020 were selected as the study objects, and they were divided into observation group (43 cases) and control group (42 cases) by lottery method. Both groups underwent laparoscopic D3 radical resection for rectal cancer. The observation group retained LCA, while the control group did not. Perioperative indexes and complication rate were compared between the two groups. Gastrointestinal function (motilin, gastrin, gastrointestinal quality of life index scale [GIQLI] score) and anal function (anal canal resting pressure, anal canal maximum systolic pressure, constipation scoring system [Wexner] score) were compared between the two groups before and after surgery. Kaplan-Meier method was used to plot the survival curve of patients, and the survival after two years of follow-up was compared. Results The first anal exhaust time and hospital stay in the observation group were shorter than those in the control group, and the free proportion of spleen flexion was lower than that in the control group (P＜0.05). The total complication rate of observation group was lower than that of control group (P＜0.05). After operation, the levels of motilin and gastrin in the two groups were lower than those before operation, and GIQLI score was increased, and the levels of motilin and gastrin in the observation group were higher than those in the control group, and GIQLI score was higher than that in the control group (P＜0.05). After surgery, the resting pressure and maximum systolic pressure of the anal canal in both groups decreased, while Wexner score increased, the resting pressure and maximum systolic pressure of the anal canal in the observation group were higher than those in the control group, while Wexner score was lower than those in the control group (P＜0.05). There was no significant difference in survival between the two groups (P＞0.05). Conclusion Retained of LCA in laparoscopic D3 radical resection of rectal cancer can shorten the time of first exhaust, reduce the incidence of postoperative complications, and accelerate the recovery of gastrointestinal and anal functions, with a good long-term prognosis.
陈德忠 常剑 王璋瑜. 保留左结肠动脉对直肠癌腹腔镜D3根治术后胃肠、肛门功能的影响[J]. 中国医药导报, 2023, 20(2): 101-104.
CHEN Dezhong CHANG Jian WANG Zhangyu. Effect of retained the left colonic artery on gastrointestinal and anal function after laparoscopic D3 radical operation for rectal cancer. 中国医药导报, 2023, 20(2): 101-104.
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