Abstract: Objective To analyze the effect of preserving the left colon artery in minimally invasive surgery for rectal cancer. Methods From January 2018 to December 2019, 60 patients with rectal cancer undergoing minimally invasive surgery were selected and grouped according to whether they had retained the left colon artery. Thirty patients in the test group retained the left colon artery and thirty patients in the control group did not retain the left colon artery. The perioperative indicators, surgical outcome, postoperative recovery and follow-up were compared between the two groups. Results There were no significant differences in intraoperative blood loss, distance between anastomotic site and dentate line, tumor diameter, number of lymph node dissection and operation time between the two groups (P>0.05). The incidence of free splenic flexure, ischemic change of residual ends and anastomotic fistula was found to be lower in the experimental group than that in the control group (P<0.05). However, there was no significant difference in the incidence of abdominal infection, intestinal obstruction, incision infection (P>0.05). There was no significant difference in postoperative time of getting out of bed, exhaust and hospitalization between the two groups (P>0.05). Comparison of metastasis rate and recurrence rate after postoperative follow-up between the two groups showed no significant difference (P>0.05). Conclusion The preservation of the left colon artery in minimally invasive surgery for rectal cancer has a good effect, which is equivalent to the preservation of the left colon artery. It can significantly reduce the incidence of free splenic flexure, ischemic changes of the stump, anastomotic fistula, and does not increase the long-term metastasis rate and recurrence rate, which can promote postoperative rehabilitation of patients, and is worthy of popularization and research.

Key words: rectal cancer, minimally invasive surgery, preserve the left colonic artery, effects

摘要： 目的 分析直肠癌微创手术中保留左结肠动脉对手术效果的影响。方法 于2018年1月~2019年12月,选取直肠癌微创手术患者60例,根据其有无保留左结肠动脉分组,试验组30例保留左结肠动脉,对照组30例未保留左结肠动脉。比较两组围术期指标、手术结局、术后恢复及随访情况。结果 两个组别术中出血量、吻合口距齿状线距离、肿瘤直径、淋巴结清扫数目、手术时间等对比发现差异不显著（P>0.05）。两个组别游离脾曲、残端缺血性改变、吻合口瘘等发生率对比发现试验组均低于控制组（P<0.05）;但二者腹腔感染、肠梗阻、切口感染等发生率对比发现差异不显著（P>0.05）。两个组别术后下床、排气、住院等时间对比发现差异不显著（P>0.05）。两个组别术后随访转移率、复发率等对比发现差异不显著（P>0.05）。结论 直肠癌微创手术中保留左结肠动脉的效果良好,等同于不保留左结肠动脉,可明显减少游离脾曲、残端缺血性改变、吻合口瘘等发生率,且不增加远期转移率和复发率,可促进患者术后康复,值得推广研究。

关键词: 直肠癌, 微创手术, 保留左结肠动脉, 效果影响