比较腹腔镜直肠癌前切除术中保留左结肠动脉3年随访结果。

对2015年11月至2017年8月接受手术治疗的95例直肠癌患者的病例资料进行回顾性分析，根据术中是否保留左结肠动脉分为保留组(46例)和未保留组(49例)。采用SPSS 23.0统计分析软件，手术相关指标、胃肠道功能及排尿功能等符合正态分布的计量资料以(±s)表示，采用独立样本t检验；复发率、并发症总发生率以率表示，以χ²检验。P<0.05为差异有统计学意义。

保留组手术时间较未保留组延长，术后排气时间较未保留组缩短，术中出血量较未保留组增多(P<0.05)。两组淋巴结清扫总数、肠管远近切缘长度、住院时间、术后3年复发率及生存率相比，差异均无统计学意义(P>0.05)。保留组术后胃肠道生活质量评分、膀胱功能评定量表评分均比未保留组高(P<0.05)。保留组术后并发症总发生率为6.5%，比未保留组22.4%低，差异有统计学意义(P<0.05)。

腹腔镜直肠癌前切除术中保留左结肠动脉的近期疗效较好，可改善患者胃肠道及排尿功能，降低并发症风险，但对于远期预后无明显影响。

To compare the 3-year follow-up results of patients underwent laparoscopic anterior resection of rectal cancer with the preservation of left colon artery.

The clinical data of 95 patients with rectal cancer who underwent surgery from November 2015 to August 2017 were analyzed retrospectively. According to the preservation of left colon artery during the operation, 46 cases were divided into the preservation group while 49 cases were divided into the non-preservation group. Statistical analysis were performed by using SPSS 23.0 software. The normally distributed measurement data such as operation-related indicators, gastrointestinal function and urinary function were expressed as(±s), and were examined by using independent sample t-test. The incidence of complications expressed as the percentage were examined by using χ² test. A P value of <0.05 was considered as statistically significant difference.

Compared with the non-preservation, increased operation time, shortened postoperative exhausting time, and increased intraoperative blood loss were observed in the preservation group(P<0.05). There were no significant difference between the two groups in terms of the harvested lymph nodes, the length of proximal and distal margin, the time of hospitalization, and the recurrence and survival rate after 3 years (P>0.05). In the preservation group, the postoperative GIQLI score and bladder function rating scores were significantly higher than those in the non-preservation group respectively (P<0.05). The incidence of complications of 6.5% in the preservation group was much lower than 22.4% in the non-preservation group (P<0.05).

The short-term outcome of laparoscopic anterior resection of rectal cancer with the preservation of left colon artery is better, with improved gastrointestinal and urinary function, and reduced postoperative complications, however with no obvious advantage in the long-term outcome.