Short-term efficacy of laparoscopic-assisted radical resection with left colonic artery preservation in elderly patients with rectal cancer
10.3760/cma.j.issn.0254-9026.2022.04.017
- VernacularTitle:保留左结肠动脉的腹腔镜辅助直肠癌根治术对老年直肠癌患者近期疗效分析
- Author:
Tao YU
1
;
Qi AN
;
Xianglong CAO
;
Jian CUI
;
Zijian LI
;
Gang XIAO
;
Guoju WU
Author Information
1. 北京医院普通外科 国家老年医学中心 中国医学科学院老年医学研究所 100730
- Keywords:
Rectal cancer;
Left colonic artery
- From:
Chinese Journal of Geriatrics
2022;41(4):447-450
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the short-term efficacy of left colonic artery preservation in laparoscopic-assisted radical resection in elderly patients with rectal cancer.Methods:168 patients aged 65 and over who had undergonelaparoscopic-assisted radical resection of rectal cancer in the gastrointestinal surgery department of Beijing Hospital from December 2017 to December 2020 were retrospectively analyzed.According to different surgical methods, they were divided into the observation group with 90 subjects(the LCA group)and the control group with 78 subjects(the non-LCA group).Basic data, intraoperative, postoperative and clinicopathological data of the two groups were compared and analyzed.Results:There were no statistically significant differences between the two groups in operative time[(172.3±35.5)min vs.(155.5±28.7)min, t=2.182, P=0.103], intraoperative blood loss[(72.6±22.5)ml vs.(67.3±18.4)ml, t=1.473, P=0.128], number of group 253 lymph nodes dissected[(3.8±1.5) vs.(4.2±1.6), t=0.785, P=0.221], and total number of lymph nodes dissected[(14.1±4.3) vs.(15.8±5.0), t=1.652, P=0.113].There was no significant difference in the incidence of anastomotic hemorrhage[4.4%(4/90) vs.3.8%(3/78), χ2=1.182, P=0.133]and the incidence of urinary retention[4.4%(4/90) vs.6.4%(5/78), χ2=1.785, P=0.148].The time to first postoperative flatus[(52.4±23.2)h vs.(68.3±29.3)h, t=2.652, P=0.023]and length of postoperative hospital stay[(9.07±3.56)d vs.(10.68±4.94)d, t=2.785, P=0.017]in the LCA group were shorter than those in the non-LCA group.The incidences of anastomotic leakage in the LCA group and the non-LAC group were 2.2%(2/90)and 5.1%(4/78), respectively, and the difference was statistically significant( t=3.575, P=0.001). Conclusions:LCA preservation in laparoscopic-assisted radical resection of rectal cancer in elderly patients with rectal cancer is safe and feasible, reduces the incidence of anastomotic leakage, and shorten the time to first postoperative flatus and length of postoperative hospital stay.It has good practical clinical value.
