Efficacy and prognostic impact of preserving the left colic artery during laparoscopic radical resection for rectal cancer

doi:10.3877/cma.j.issn.1674-3946.2026.03.015

Abstract

Abstract:

Objective

To investigate the efficacy and prognostic impact of preserving the left colic artery during laparoscopic radical resection for rectal cancer.

Methods

A total of 108 patients with rectal cancer admitted from January 2021 to December 2021 were enrolled and randomly divided into an observation group (n=54) and a control group (n=54). All patients underwent laparoscopic radical resection for rectal cancer. The left colic artery was preserved in the observation group but not in the control group. Perioperative indicators, incidence of postoperative complications, gastrointestinal function, anal function, recurrence rate, and liver metastasis rate were compared between the two groups. Statistical analysis was performed using SPSS 22.0 software. Enumeration data were expressed as rates (%) and analyzed by the χ² test. Measurement data conforming or approximately conforming to a normal distribution were expressed as (

x ¯

±s) and analyzed by the t test. P<0.05 was considered statistically significant.

Results

The length of hospital stay was significantly shorter in the observation group than in the control group (t=3.638, P<0.001). At 1 month after surgery, the complication rate in the observation group was 7.4% (4/54), which was significantly lower than 22.2% (12/54) in the control group (χ²=4.696, P=0.030<0.05). The levels of gastrointestinal function and anal function indexes in the observation group were significantly higher than those in the control group (t=5.017, 4.208, 3.424, 3.287, P<0.05). At 2 years after surgery, there were no significant differences in the recurrence rate and liver metastasis rate between the two groups (χ²=2.080, 0.101; P=0.149, 0.750>0.05).

Conclusion

Preserving the left colic artery during laparoscopic radical resection for rectal cancer can reduce the incidence of complications and promote postoperative recovery.

Key words: Rectal Tumor, Laparoscopic Radical Resection of Rectal Cancer, Left Colic Artery, Postoperative Complications, Recurrence

Junkang Zhao, Qianjin Zhang, Huijie Zhuang. Efficacy and prognostic impact of preserving the left colic artery during laparoscopic radical resection for rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2026, 20(03): 257-260.

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URL: https://zhpwkssxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3946.2026.03.015

https://zhpwkssxzz.cma-cmc.com.cn/EN/Y2026/V20/I03/257

Figures/Tables 5

组别	例数	性别（例）	年龄（岁， $x ¯$ ±s）	肿瘤类型（例）
组别	例数	男/女	年龄（岁， $x ¯$ ±s）	管状腺癌	乳头状腺癌	黏液腺癌
观察组	54	31/23	56.8±5.4	26	15	13
对照组	54	29/25	55.5±5.6	28	14	12
t/χ²值		0.150	1.228		0.149
P值		0.699	0.222		0.928
组别	例数	肿瘤分期（例）			体质量（kg/m²， $x ¯$ ±s）	合并高血压（例）	合并糖尿病（例）
组别	例数	Ⅰ期	Ⅱ期	Ⅲ期	体质量（kg/m²， $x ¯$ ±s）	合并高血压（例）	合并糖尿病（例）
观察组	54	15	23	16	24.3±2.1	8	6
对照组	54	13	22	19	23.9±2.3	7	5
t/χ²值		0.422			1.228	0.077	0.101
P值		0.810			0.222	0.781	0.750

组别	例数	性别（例）	年龄（岁， $x ¯$ ±s）	肿瘤类型（例）
组别	例数	男/女	年龄（岁， $x ¯$ ±s）	管状腺癌	乳头状腺癌	黏液腺癌
观察组	54	31/23	56.8±5.4	26	15	13
对照组	54	29/25	55.5±5.6	28	14	12
t/χ²值		0.150	1.228		0.149
P值		0.699	0.222		0.928
组别	例数	肿瘤分期（例）			体质量（kg/m²， $x ¯$ ±s）	合并高血压（例）	合并糖尿病（例）
组别	例数	Ⅰ期	Ⅱ期	Ⅲ期	体质量（kg/m²， $x ¯$ ±s）	合并高血压（例）	合并糖尿病（例）
观察组	54	15	23	16	24.3±2.1	8	6
对照组	54	13	22	19	23.9±2.3	7	5
t/χ²值		0.422			1.228	0.077	0.101
P值		0.810			0.222	0.781	0.750

组别	例数	淋巴结清扫数目（枚， $x ¯$ ±s）	手术时间（min， $x ¯$ ±s）	术中出血量（ml， $x ¯$ ±s）	住院时间（d， $x ¯$ ±s）	预防性造口[例（%）]
观察组	54	14.2±2.8	158.8±12.8	86.8±8.5	14.7±3.1	9（16.7）
对照组	54	13.6±2.9	154.9±13.7	85.6±8.7	16.9±3.1	11（20.4）
t值		1.094	1.529	0.725	3.688	0.246
P值		0.277	0.129	0.470	<0.001	0.620

组别	例数	淋巴结清扫数目（枚， $x ¯$ ±s）	手术时间（min， $x ¯$ ±s）	术中出血量（ml， $x ¯$ ±s）	住院时间（d， $x ¯$ ±s）	预防性造口[例（%）]
观察组	54	14.2±2.8	158.8±12.8	86.8±8.5	14.7±3.1	9（16.7）
对照组	54	13.6±2.9	154.9±13.7	85.6±8.7	16.9±3.1	11（20.4）
t值		1.094	1.529	0.725	3.688	0.246
P值		0.277	0.129	0.470	<0.001	0.620

组别	例数	吻合口出血	吻合口漏	腹腔感染	肺部感染	总发生
观察组	54	2（3.7）	0（0.0）	1（1.9）	1（1.9）	4（7.4）
对照组	54	4（7.4）	5（9.3）	2（3.7）	1（1.9）	12（22.2）
χ²值		0.706	5.243	0.343	-	4.696
P值		0.401	0.022	0.558	1.000	0.030

组别	例数	胃动素		胃泌素
组别	例数	术前	术后1个月	术前	术后1个月
观察组	54	136.8±19.3	103.4±11.6	315.9±34.7	274.5±26.8
对照组	54	134.9±20.1	91.8±12.4	312.9±35.5	252.4±27.8
t值		0.501	5.020	0.444	4.206
P值		0.617	<0.001	0.658	<0.001

组别	例数	肛管静息压		肛管最大收缩压
组别	例数	术前	术后1个月	术前	术后1个月
观察组	54	49.6±3.5	43.7±2.7	142.4±14.5	134.7±10.8
对照组	54	48.9±3.7	41.9±3.0	141.2±14.7	127.8±11.1
t值		1.010	3.277	0.427	3.274
P值		0.315	0.001	0.670	0.001

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