CAJ | 학술논문

目的：探讨保留左结肠动脉和直肠上动脉的上段直肠癌手术的可行性及益处，并与传统术式比较。方法纳入2011年1月—2013年6月拟行腹腔镜直肠癌根治术的上段直肠癌患者59例，分为试验组（n=30）及对照组（n=29）。试验组行保留左结肠动脉和直肠上动脉的经腹直肠切除吻合术，对照组行传统术式。比较两组手术时间、淋巴结清扫数目、出血量、吻合口愈合情况。结果试验组患者手术时间长于对照组，出血量大于对照组，差异有统计学意义（P<0.05）；淋巴结清扫数目相比差异无统计学意义（P>0.05）；试验组患者无发生吻合口瘘，对照组有2例发生。结论上段直肠癌患者行经腹直肠切除吻合术可保留左结肠动脉和直肠上动脉以降低吻合口瘘发生概率。
목적：탐토보류좌결장동맥화직장상동맥적상단직장암수술적가행성급익처，병여전통술식비교。방법납입2011년1월—2013년6월의행복강경직장암근치술적상단직장암환자59례，분위시험조（n=30）급대조조（n=29）。시험조행보류좌결장동맥화직장상동맥적경복직장절제문합술，대조조행전통술식。비교량조수술시간、림파결청소수목、출혈량、문합구유합정황。결과시험조환자수술시간장우대조조，출혈량대우대조조，차이유통계학의의（P<0.05）；림파결청소수목상비차이무통계학의의（P>0.05）；시험조환자무발생문합구루，대조조유2례발생。결론상단직장암환자행경복직장절제문합술가보류좌결장동맥화직장상동맥이강저문합구루발생개솔。
Objective To observe the feasibility and benefits of preservation of left colic artery and superior rectal artery for the treatment of upper rectum carcinoma. Methods From January 2011-June 2013,59 patients with upper rectum carcinoma were divided into experimental group(n=30)and control group(n=29). Experimental group kept left colic artery and superior rectal artery,control group received conventional surgery. Operation time,number of lymph node cleaning,blood loss and anastomotic healing between two groups were compared. Results Longer operating time and greater blood loss in the experimental group were observed as compared to the control group(all P<0.05);but number of lymph node cleaning had no statistical significance. And,anastomotic fistula wasn’t found in the experimental group,however two of anastomotic fistula occurred in the control group. Conclusions Preservation of left colic artery and superior rectal artery is good for the treatment of upper rectum carcinoma,and could reduce the risk of anastomotic fistula in the patients with upper rectum carcinoma.