Feasibility and safety of laparoscopic total mesorectal excision with preservation of left colic artery in the treatment of middle and low rectal cancer
Objective To investigate the feasibility and safety of laparoscopic total mesorectal excision(TME)with preservation of left colic artery(LCA)in the treatment of middle and low rectal cancer.Methods A total of 98 patients with middle and low rectal cancer treated by laparoscopic TME in our hospital from January 2019 to January 2022 were selected as the research objects.According to the difference of treatment plan,the patients were divided into control group(49 cases,laparoscopic TME without preservation of LCA)and study group(49 cases,laparoscopic TME with preservation of LCA).The therapeutic effects of the two groups were compared.Results There were no significant differences in intraoperative blood loss,number of lymph node dissection and distance from anastomosis to anal margin between the two groups(P＞0.05);the marginal aortic arch pressure of the study group was lower than that of the control group,and the postoperative ventilation time and hospitalization time were shorter than those of the control group(P＜0.05).At 3 d after operation,the levels of motilin,gastrin,anal resting pressure and anal maximum systolic pressure in the two groups were lower than those before operation,and the maximum tolerable volume of rectum was smaller than that before operation(P＜0.05);at 3 d after operation,the levels of motilin,gastrin,anal resting pressure and anal maximum systolic pressure in the study group were higher than those in the control group,and the maximum tolerable volume of rectum was greater than that in the control group(P＜0.05).At 3 d after operation,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)and interleukin-1β(IL-1 β)in the two groups were higher than those before operation,but those in the study group were lower than the control group(P＜0.05).The total incidence of complications in the study group was lower than that in the control group(P＜0.05).Conclusion The laparoscopic TME with preservation of LCA in the treatment of middle and low rectal cancer has significant effect,with minimal impact on gastrointestinal motility and anal function,mild inflammatory reactions in the body,and ideal prognosis recovery for patients,which has high application value.
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