Abstract:

【Abstract】 Objective To explore the effect and safety of preservation of the left colic artery (LCA) for the treatment of sigmoid colon cancer. Methods A total of 75 cases with sigmoid colon cancer were included in the study and the clinical data were analyzed retrospectively. Of 75 cases, 32 underwent radical dissection with LCA preservation (LCA preservation group), the ones who underwent traditional surgery with cutting the root of inferior mesenteric artery were controls. The surgical effect, clinical pathological parameters and postoperative complications were compared between two groups. Results There were no differences in surgical time and blood loss between LCA preservation group and traditional group. The proximal bowel cut end (11.5cm vs 16.7cm) and distal bowel cut end (5.8 cm vs 8.7 cm) were both shorter in the LCA preservation group. We found no difference in the amount of postoperative harvested lymph nodes. The main group of harvested lymph nodes (2.3 vs 2.1) and positive lymph nodes (0.2 vs 0.3) were similar between two groups. We also found that the incidences of overall complications were similar between LCA preservation group and traditional group. Conclusion The application of LCA preservation for the treatment of sigmoid colon cancer was available, safe and effective and ensured radical dissection of lymph nodes along the root of inferior mesenteric artery, with no risk in improving surgical risk.

Key words: Left colic artery, Inferior mesenteric artery, Sigmoid colon cancer

摘要： 【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(n=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(11.5 cm vs 16.7 cm)和远端肠管(5.8 cm vs 8.7 cm)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 vs 2.1枚)及阳性淋巴结个数(0.2枚 vs 0.3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