Clinical study of three-dimensional CT reconstruction technology guiding preserving the left colonic artery during laparoscopic radical resection of rectal cancer
- VernacularTitle:三维CT重建技术指导腹腔镜下直肠癌根治术中保留左结肠动脉的临床研究
- Author:
Jun-feng OUYANG
1
;
Yan FU
1
;
Wen-qiang SHEN
1
;
Yu-fei HU
1
Author Information
- Publication Type:Journal Article
- Keywords: rectal cancer; left colonic artery; high ligation; low ligation; anastomotic leakage; three-dimensional CT reconstruction
- From: Journal of Regional Anatomy and Operative Surgery 2025;34(1):58-61
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the significance and clinical value of preoperative three-dimensional CT reconstruction of the whole abdomen guiding preserving the left colonic artery during laparoscopic radical resection of rectal cancer. Methods Patients with rectal cancer who underwent laparoscopic radical resection of rectal cancer in our hospital from January 2021 to January 2022 were selected,then 87 patients with left colonic artery were screened out through three-dimensional CT reconstruction of the whole abdomen before surgery,who were randomly divided into the observation group (received intraoperative low ligation of the inferior mesenteric artery,with preservation of the left colonic artery) with 40 cases and the control group (received intraoperative high ligation of the inferior mesenteric artery without preservation of the left colonic artery) with 47 cases. The perioperative indexes and postoperative pathological results of the two groups were compared. Results The intraoperative blood loss in the observation group was higher than that in the control group,and the operation time was longer than that in the control group,with statistically significant differences (P<0.05). The incidences of postoperative intestinal obstruction and anastomotic leakage in the observation group were lower than those in the control group,and the first postoperative discharge time was earlier than that in the control group,with statistically significant differences (P<0.05). There was no significant difference in the degree of tumor differentiation,tumor size,adenocarcinoma classification,number of lymph nodes dissected at the root of the inferior mesenteric artery,or the stage of intestinal wall invasion depth of tumor between the two groups (P>0.05). Conclusion The application of the three-dimensional CT reconstruction of the whole abdomen before surgery can understand the branch classification of the inferior mesenteric artery in advance,determine the location of the tumor and its adjacent relationship with the surrounding tissues,and determine the resection extent of intestinal segment. Intraoperative preservation of the left colonic artery can reduce the occurrence of postoperative complications in patients,which has positive clinical significance.
