国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2013年
11期
738-742,封4
,共6页
韩玉栋%林晨%张再重%涂小煌
韓玉棟%林晨%張再重%塗小煌
한옥동%림신%장재중%도소황
癌%肠系膜下动脉%高位结扎%低位结扎%直肠癌根治术%外科手术
癌%腸繫膜下動脈%高位結扎%低位結扎%直腸癌根治術%外科手術
암%장계막하동맥%고위결찰%저위결찰%직장암근치술%외과수술
Carcinoma%Mesenteric artery inferior%High ligation%Low ligation%Radical resection for rectal cancer%Surgical procedures,operative
目的 探讨肠系膜下动脉(IMA)低位结扎与高位结扎并根部淋巴结廓清对直肠癌根治术的意义.方法 对2007年5月-2008年5月收治的156例直肠癌患者进行回顾性分析,低位结扎组80例,高位结扎组76例.低位结扎组采用肠系膜下动脉低位结扎并根部淋巴结廓清,高位结扎组采用肠系膜下动脉高位结扎并根部淋巴结廓清.比较两组IMA根部淋巴结转移率、淋巴结清扫数量、复发率、5年生存率及并发症发病率,并进行统计学分析.结果 低位结扎组IMA根部淋巴结转移率为15.0％,高位结扎组IMA根部淋巴结转移率为14.5％,两组比较差异无统计学意义(P＞0.05);对比两组术后复发率、5年生存率、吻合口瘘、性功能障碍和尿潴留的发病率,差异均无统计学意义(P＞0.05);低位结扎组肠道功能恢复时间、低位直肠前切除综合征的发病率低于高位结扎组,两组比较差异有统计学意义(P＜0.05).结论 肠系膜下动脉低位结扎并根部淋巴结廓清可达到直肠癌根治.与传统IMA高位结扎相比,对患者的复发率、5年生存率及并发症发病率无影响.
目的 探討腸繫膜下動脈(IMA)低位結扎與高位結扎併根部淋巴結廓清對直腸癌根治術的意義.方法 對2007年5月-2008年5月收治的156例直腸癌患者進行迴顧性分析,低位結扎組80例,高位結扎組76例.低位結扎組採用腸繫膜下動脈低位結扎併根部淋巴結廓清,高位結扎組採用腸繫膜下動脈高位結扎併根部淋巴結廓清.比較兩組IMA根部淋巴結轉移率、淋巴結清掃數量、複髮率、5年生存率及併髮癥髮病率,併進行統計學分析.結果 低位結扎組IMA根部淋巴結轉移率為15.0％,高位結扎組IMA根部淋巴結轉移率為14.5％,兩組比較差異無統計學意義(P＞0.05);對比兩組術後複髮率、5年生存率、吻閤口瘺、性功能障礙和尿潴留的髮病率,差異均無統計學意義(P＞0.05);低位結扎組腸道功能恢複時間、低位直腸前切除綜閤徵的髮病率低于高位結扎組,兩組比較差異有統計學意義(P＜0.05).結論 腸繫膜下動脈低位結扎併根部淋巴結廓清可達到直腸癌根治.與傳統IMA高位結扎相比,對患者的複髮率、5年生存率及併髮癥髮病率無影響.
목적 탐토장계막하동맥(IMA)저위결찰여고위결찰병근부림파결곽청대직장암근치술적의의.방법 대2007년5월-2008년5월수치적156례직장암환자진행회고성분석,저위결찰조80례,고위결찰조76례.저위결찰조채용장계막하동맥저위결찰병근부림파결곽청,고위결찰조채용장계막하동맥고위결찰병근부림파결곽청.비교량조IMA근부림파결전이솔、림파결청소수량、복발솔、5년생존솔급병발증발병솔,병진행통계학분석.결과 저위결찰조IMA근부림파결전이솔위15.0％,고위결찰조IMA근부림파결전이솔위14.5％,량조비교차이무통계학의의(P＞0.05);대비량조술후복발솔、5년생존솔、문합구루、성공능장애화뇨저류적발병솔,차이균무통계학의의(P＞0.05);저위결찰조장도공능회복시간、저위직장전절제종합정적발병솔저우고위결찰조,량조비교차이유통계학의의(P＜0.05).결론 장계막하동맥저위결찰병근부림파결곽청가체도직장암근치.여전통IMA고위결찰상비,대환자적복발솔、5년생존솔급병발증발병솔무영향.
Objective To evaluate the clinical significance of low ligation and high ligation of inferior mesenteric artery (IMA) and lymph nodes dissection on radical resection for rectal cancer.Methods One hundred and fifty-six patients who were diagnosed rectal cancer in our hospital between May 2007 and May 2008 were divided into low ligation group (80 cases)and high ligation group (76 cases).The low ligation group was treated with low ligation of IMA and lymph nodes dissection,the high ligation group was cured by high ligation of IMA and lymph nodes dissection.cases.The IMA lymph nodes metastasis,number of lymph nodes,cancer recurernce rate,5-year survival rate,complication rate were compared and analyzed.Results The rate of lymph nodes metastasis around the origin of inferior mesenteric artery was 15.0％ in the low ligation group,the rate of lymph nodes metastasis around the origin of inferior mesenteric artery was 14.5％ in the high ligation group,and the difference was not statistically significant (P ＞ 0.05).Compared two groups of postoperative recurrence rate,5-year survival rate,anastomotic leakage rate,sexual dysfunction rate and urinary retention rate,there was no significant differences (P ＞ 0.05).The intestinal function recovery time and low anterior resection syndrome incidence of the low ligation group were lower than the high ligation group,there were significant differences (P ＜ 0.05).Conclusions Low ligation of inferior mesenteric artery and lymph nodes dissection can achieve radical resection for rectal cancer.Compared with traditional high ligation of inferior mesenteric artery,there were no differences for patients on recurrence rate,5-year survival rate and complication rate.
