分析肠系膜下动脉(IMA)低位结扎和高位结扎对腹腔镜直肠癌根治术的疗效影响。

以2013年3月至2017年3月收治的215例接受腹腔镜直肠癌根治术的患者为研究对象，进行回顾性分析。按照患者治疗术式，将接受IMA低位结扎者纳入低位结扎组127例，将接受IMA高位结扎者纳入高危结扎组88例。采用SPSS18.0进行分析，术后短期并发症发生情况采用χ²检验；手术情况、恢复情况等计量资料以(±s)表示，独立t检验，以P<0.05为差异有统计学意义。

低位结扎组术中残端缺血性改变发生率和术后首次排气时间均低于高位结扎组，其术后性功能障碍或尿失禁发生率高于后者，差异有统计学意义(P<0.05)。

腹腔镜直肠癌根治术中，两种结扎方式疗效相当，IMA低位结扎对于患者术后早期恢复具有积极意义，但较高危结扎有着更高的盆腔自主神经损伤风险，需根据患者实际情况做出决策。

To analyze the effect of low ligation and high ligation of inferior mesenteric artery (IMA) on laparoscopic radical resection of rectal cancer.

A total of 215 patients undergoing laparoscopic radical resection for rectal cancer were selected from March 2013 to March 2017 for this retrospective study. According to the operative method, 127 patients treated with low ligation of IMA were enrolled in the low ligation group (n=127), while the patients with high ligation of IMA were enrolled in the high ligation group (n=88). The data was analyzed by SPSS 18.0, short-term postoperative complications were examined by χ² test; the data of operation and recovery were represented by (±s) and examined by t test, P<0.05 showed that the difference was statistically significant.

The margin ischemic change rate, postoperative exhaust time for the first time of low ligation group were lower than those in the high ligation group, the postoperative sexual dysfunction or urinary incontinence rate was higher than that of the latter, the differences were statistically significant (P<0.05).

The effect of two ligation methods is quite good. IMA low ligation has positive significance for early postoperative recovery, but it has higher risk of pelvic autonomic nerve damage than high ligation. The decisions should be made based on the patient's actual situation.