Clinical comparison of laparoscopic radical resection of rectal cancer with preservation of left colonic artery through different approaches
10.3760/cma.j.cn115455-20240613-00499
- VernacularTitle:不同入路保留左结肠动脉腹腔镜直肠癌根治术的临床对比
- Author:
Zongtao ZHANG
1
;
Jingjing CHEN
1
;
Yongmei XIA
1
;
Baogui ZHANG
1
;
Shiqi LIU
1
Author Information
1. 济宁医学院附属医院胃肠外科，济宁 276899
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms;
Laparoscopic radical resection of rectal cancer;
Mesorectal excision;
Left colonic artery;
Surgical approach
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(3):215-220
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the application effects of different approaches (bilateral approach, traditional intermediate approach) in laparoscopic radical resection of rectal cancer with preservation of left colonic artery (LCA).Methods:The data of 120 patients undergoing laparoscopic radical resection of rectal cancer from January 2021 to December 2023 were retrospectively analyzed. Based on the different surgical approaches chosen for preserving LCA, 67 patients who underwent traditional intermediate approach to preserve LCA were included in the control group, while the remaining 53 patients who underwent bilateral approach to preserve LCA were included in the study group. The results of the main outcome indicators were recorded and the differences between the groups were compared, including perioperative indicators; lymph node dissection; gastrointestinal hormones (gastrin and motilin) before operation and 2 d after operation; postoperative complications such as anastomotic bleeding, anastomotic leakage, and urinary dysfunction.Results:Compared with the control group, the study group had longer surgical time and more intraoperative bleeding: (132.68 ± 11.24) min vs. (126.54 ± 10.45) min, (78.41 ± 5.35) ml vs. (75.22 ± 5.10) ml, the difference was statistically significant ( P = 0.003 and 0.001). However, there was no significant difference in exhaust time and hospitalization time between the two groups ( P>0.05). There was no significant difference in total lymph node clearance between the two groups ( P>0.05). The number of lymph node dissection in the 253 groups of the study group was higher than that in the control group: (5.18 ± 1.26) pieces vs. (4.35 ± 1.32) pieces, the difference was statistically significant ( P = 0.001). On the second day after surgery, the serum gastrin and motilin in both groups decreased compared to before surgery, but there was no significant difference between the two groups ( P>0.05). The incidence of postoperative urinary dysfunction in the study group was lower than that in the control group: 0 vs. 10.45% (7/67), the difference was statistically significant ( P = 0.015). Conclusions:Compared with the traditional intermediate approach for laparoscopic radical resection of rectal cancer with preserved LCA, the bilateral approach, although having a longer surgical time and slightly more intraoperative bleeding, can effectively clean 253 lymph nodes and reduce postoperative urinary dysfunction.
