| Objective: To explore the short-term curative effect and advantages of laparoscopic radical resection of left colon cancer with preservation of inferior mesenteric artery,and provide reference for the promotion and application of laparoscopic radical resection of left colon cancer with preservation of inferior mesenteric artery.Methods: Collect and organize patients with left colon cancer who were hospitalized in the Department of Gastrointestinal Surgery of the Affiliated Hospital of Youjiang Medical College for Nationalities between January 1,2020 and December 1,2022.The data of the patients were divided into two groups,one group was the inferior mesenteric artery group,and the other group was the inferior mesenteric artery group.In the end,there were 16 cases in the inferior mesenteric artery group and 27 cases in the non-inferior mesenteric artery group.The age,gender,body mass index(BMI),tumor location,tumor size,tumor stage,recent complications,operation time,intraoperative blood loss,postoperative drainage volume,and postoperative first day were recorded in the two groups of patients.The short-term clinical curative effect of the two surgical methods was compared by data such as the time of one exhaust,the pain VAS score(visual analogue scale,VAS)on the first day after operation,and the postoperative hospital stay;The effect of two different surgical methods on the length of intestinal canal resection;the contents of albumin and prealbumin before operation and the contents of albumin and prealbumin on the first day,the third day and the seventh day after operation were recorded respectively in the two groups,To compare the effects of two different surgical methods on the nutritional status of the patients;to record the number of lymph node dissections in the two groups of patients to compare the difference in the extent of lymph node dissection between the two different surgical methods.Results: Comparison of short-term clinical curative effect between the two groups: the average operation time of the inferior mesenteric artery group and the group without inferior mesenteric artery were 207.81±55.14 points and 206.67±56.84 points respectively,and there was no significant difference in statistical analysis(P=0.949 >0.05);the average intraoperative blood loss in the inferior mesenteric artery group and the non-inferior mesenteric artery group were 78.13±51.54 ml and 78.52±62.49 ml respectively,and there was no significant difference in statistical analysis(P=0.983 > 0.05);The postoperative first exhaust time of the inferior mesenteric artery group and the group without inferior mesenteric artery were 4.19±1.60 days and 4.48±2.36 days respectively,and there was no significant difference in statistical analysis(P=0.662>0.05);The average value of pain score(VAS score)on the first day after operation in the artery group and the group without inferior mesenteric artery was 3.88±1.02 points and 4.15±1.68 points respectively,and there was no significant difference in statistical analysis(P=0.560 > 0.05);The average postoperative drainage volumes of the inferior mesenteric artery and non-preservation inferior mesenteric artery groups were 761.88±560.85 ml and 819.07±1269.70 ml respectively,and there was no significant difference in statistical analysis(P=0.866>0.05);the inferior mesenteric artery group The average postoperative hospital stay of the group without and without inferior mesenteric artery was 13.63±8.30 days and 10.37±3.09 days,respectively,and there was no significant difference in statistical analysis(P=0.150>0.05);The average values of albumin and prealbumin in the inferior artery group and the group without inferior mesenteric artery were 40.25±6.03g/L,39.64±3.50g/L and 181.74±39.23g/L,192.18±47.30g/L,respectively.L,there was no significant difference in the statistical analysis between the two(P=0.674>0.05,P=0.462>0.05);the average value of albumin and prealbumin on the first day after operation in the inferior mesenteric artery group and the group without inferior mesenteric artery They were 32.21±5.07g/L,32.47±4.76g/L and 130.84±41.72g/L,143.85±39.85g/L respectively,and there was no significant difference in statistical analysis between the two(P=0.869>0.05,P=0.315 > 0.05);the mean values of albumin and prealbumin in the inferior mesenteric artery group and the group without inferior mesenteric artery were 37.66±0.80g/L,35.31±1.44g/L and 119.58±19.53g/L on the third day after operation,respectively,108.19±15.91g/L,there was a statistically significant difference between the two(P=0.000<0.05,P=0.043<0.05);albumin and The mean values of prealbumin were38.53±1.54g/L,37.20±1.94g/L and 137.31±19.84g/L,126.28±13.36g/L respectively,and there was a significant difference between them(P=0.024< 0.05,P=0.035<0.05);the average bowel resection lengths of the inferior mesenteric artery group and the group without inferior mesenteric artery were 24.25±1.53 cm and 26.37±2.09 cm,respectively,and there was a significant difference in statistical analysis(P=0.001 <0.05);the average number of dissected lymph nodes in the inferior mesenteric artery group and the group without inferior mesenteric artery were 20.50±8.64 and 19.67±10.75,respectively,and there was no significant difference in statistical analysis(P=0.794>0.05).Conclusion: Laparoscopic radical resection of left hemicolon with and without inferior mesenteric artery is more effective in operation time,intraoperative blood loss,first exhaust time after operation,pain assessment on the first day after operation,and postoperative hospital stay.There was no significant difference in short-term curative effect such as postoperative drainage volume,number of lymph nodes dissected,and nutritional status such as albumin and prealbumin before operation and on the first day after operation,indicating that the two surgical methods had no significant difference in effectiveness and feasibility.However,the length of bowel resection and the comparison of albumin and prealbumin on postoperative day 3 and postoperative day 7 were significantly different,indicating that patients with laparoscopic left colon cancer with preservation of the inferior mesenteric artery can retain more If there are more normal intestines,the postoperative nutritional level will recover faster,which has a positive effect on the overall postoperative recovery.This surgical method is worthy of clinical application. |
PDF Full Text Request