Clinical study of laparoscopic radical resection of rectal cancer with preservation of left colonic artery dissection

WANG Yong-sen; XIE Yi-xiang; WANG Chuan-si; HUANG Hong-wu; GE Si-tang

doi:10.16766/j.cnki.issn.1674-4152.002354

Volume 20 Issue 3

Mar. 2022

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Article Navigation > Chinese Journal of General Practice > 2022 > 20(3): 366-370

WANG Yong-sen, XIE Yi-xiang, WANG Chuan-si, HUANG Hong-wu, GE Si-tang. Clinical study of laparoscopic radical resection of rectal cancer with preservation of left colonic artery dissection[J]. Chinese Journal of General Practice, 2022, 20(3): 366-370. doi: 10.16766/j.cnki.issn.1674-4152.002354

Citation:

WANG Yong-sen, XIE Yi-xiang, WANG Chuan-si, HUANG Hong-wu, GE Si-tang. Clinical study of laparoscopic radical resection of rectal cancer with preservation of left colonic artery dissection[J]. Chinese Journal of General Practice, 2022, 20(3): 366-370. doi: 10.16766/j.cnki.issn.1674-4152.002354

Citation:

WANG Yong-sen, XIE Yi-xiang, WANG Chuan-si, HUANG Hong-wu, GE Si-tang. Clinical study of laparoscopic radical resection of rectal cancer with preservation of left colonic artery dissection[J]. Chinese Journal of General Practice, 2022, 20(3): 366-370. doi: 10.16766/j.cnki.issn.1674-4152.002354

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Clinical study of laparoscopic radical resection of rectal cancer with preservation of left colonic artery dissection

doi: 10.16766/j.cnki.issn.1674-4152.002354

1.
Department of Colorectal Surgery, Lu'an Hospital Affiliated to Anhui Medical University, Lu'an, Anhui 237005, China

Funds:

KJ2020A0550

Received Date: 2021-03-09
Available Online: 2022-08-13

Abstract

Abstract

Objective To evaluate the safety and efficacy of laparoscopic radical resection of rectal cancer with left colonic artery (LCA) preservation and group 253 (253rd group) lymph node dissection. Methods From April 2017 to February 2021, 80 patients who underwent laparoscopic radical resection of rectal cancer in the Colorectal Surgery Department of Lu'an People's Hospital were selected and randomly divided into the observation group and control group (40 cases in each group). The observation group was given LCA preservation, and the 253rd group lymph nodes were cleaned. In the control group, LCA was not retained, but the inferior mesenteric artery was severed. The intraoperative and postoperative conditions of both groups were compared. Results Intraoperative conditions: the pressures of colonic marginal artery arch in the observation group and the control group were (47.00±9.02) mm Hg (1 mm Hg=0.133 kPa) and (37.40±7.52) mm Hg, respectively. The difference between the two groups was statistically significant (P < 0.05). In the observation group, LCA was temporarily clamped during operation, and the pressure of colonic marginal artery arch was (36.00±8.37) mm Hg. The difference before and after clipping was statistically significant (P < 0.05), but there was no significant difference between the two groups (P>0.05). There was no significant difference in operation time, intraoperative blood loss, number of lymph nodes removed in 253rd group lymph node dissection and mesenteric lymph node dissection between the two groups (all P>0.05). There was significant difference in free spleen curvature and preventive stoma rate between the two groups (all P < 0.05). Postoperative situation: there were significant differences in the incidence of anastomotic leakage and the first anal exhaust time between the two groups (all P < 0.05). Conclusion Preserving LCA and 253rd group lymph node dissection can ensure thorough dissection without increasing complications, significantly increase the pressure of proximal colonic artery arch, reduce the rate of ileostomy prevention and splenic flexure dissociation, and reduce the incidence of postoperative anastomotic leakage. It is a safe and reliable operation.
- Rectal cancer,
- Left hemicolonic artery,
- Group 253 lymph nodes,
- Arterial pressure of marginal arch,
- Laparoscopic radical resection of rectal cancer,
- Anastomotic leakage,
- Free splenic flexure

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References

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Clinical study of laparoscopic radical resection of rectal cancer with preservation of left colonic artery dissection

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Clinical study of laparoscopic radical resection of rectal cancer with preservation of left colonic artery dissection

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