Application effects of left colonic artery preservation in total mesorectal excision in patients with rectal cancer
Objective:To observe application effects of left colonic artery preservation(LCA)in total mesorectal excision(TME)in patients with rectal cancer.Methods:The clinical data of 106 patients with rectal cancer admitted to the hospital from 2019 to 2022 were retrospectively analyzed.According to whether LCA was preserved during the surgery,they were divided into control group(n=56)and study group(n=50).Both groups were treated with TME.LCA was not preserved in the control group,while LCA was preserved in the study group.The levels of perioperative indexes(operation time,intraoperative blood loss,number of lymph node dissected,first exhaust time,first feeding time,postoperative hospitalization time),the levels of T cell subsets(CD3+,CD4+,CD4+/CD8+)and anorectal function indexes[anorectal resting pressure(ARP),anorectal inhibitory reflex threshold(AIRT),high pressure zone length(HPZ)]before and after the surgery,and the incidence of complications were compared between the two groups.Results:There were no significant differences in the operation time,intraoperative blood loss and number of lymph node dissected between the two groups(P>0.05).The first exhaust time,the first feeding time and the postoperative hospitalization time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).3 and 5 days after the surgery,the levels of CD3+,CD4+and CD4+/CD8+in the two groups were lower than those before the surgery,but those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).1 and 2 weeks after the surgery,the levels of ARP and HPZ in the two groups were lower than those before the surgery,but those in the study group were higher than those in the control group;the AIRT levels of the two groups were higher than those before the surgery,but that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was 6.00%(3/50),which was lower than 25.00%(14/56)in the control group,and the difference was statistically significant(P<0.05).Conclusions:The preservation of LCA in TME for the patients with rectal cancer can promote the rehabilitation of these patients,improve the immune function and the anorectal function,and reduce the incidence of complications.Moreover,it is superior to TME without LCA preservation.
万方数据
维普
