The Effects Of Different Ligation Position On IMV In Laparoscope Radical Resection For Rectal Cancer

Background:Colorectal Cancer(CRC)is one of the most common malignant tumors of the digestive system in humans and has become a major burden worldwide.In our country,rectal cancer is still a majority of CRC.Guidelines for diagnosis and treatment of colorectal cancer in NCCN,ESMO,and Chinese guidelines consider surgical treatment as the main treatment for rectal cancer.Where to ligate blood vessels and clear lymph nodes is an important factor which influenced patient's prognosis.Attention has been paid at the beginning of the development of rectal radical surgery.At present few study had paid attention on the effect of different ligation position of inferior mesenteric vein on surgical procedure,tumor resection and recovery of bowel function.This paper preliminarily discussed the effect of different ligation position of inferior mesenteric vein and tried to provide low ligation of IMV's surgical and oncological basis.Objective:To analyse the difference of surgical indicators,oncological indicators and follow-up data between low ligation of inferior mesenteric vein(IMV)and high ligation of inferior mesenteric vein(IMV).Methods:Twenty-eight patients with rectal cancer were enrolled in a laparoscopic radical resection for the rectal cancer.All of them are randomly divided into two groups: Low inferior mesenteric vein ligation group(L group)and High inferior mesenteric vein ligation group(H group).During L group's operation,we ligated IMV on the level of the root of IMA.And we ligate IMV in the lower edge of pancreas in H group's patients.We analyse two groups' surgical indicators,oncology indicators and follow-up data to investigate the differences between Low inferior mesenteric vein ligation group(L group)and High inferior mesenteric vein ligation group(H group).Result:1.The complete data of 28 patients with rectal cancer were analysed.There was no statistical difference in gender,age,clinical symptoms,tumor location,BMI and serum albumin levels before surgery between two groups(P > 0.05).2.Operative surgery indicators:.There was no statistical difference in the operation time,intraoperative blood loss,and postoperative hospital stay time between the two groups.(P > 0.05)Low inferior mesenteric vein ligation group(L group)has a shorter time of intestinal function recovery(49.30 ± 19.88 h vs 67.83 ± 23.00 h,P < 0.05)3.Oncological indicators:There was no statistical difference in clinical stage,total lymph node dissections number and the positive lymph nodes number between two groups(P > 0.05).4.Postoperative follow-up:.There was no statistical difference in the basic data of the follow-up groups.There was no statistical difference in postoperative body scores,voiding function scores,defecation function scores,intestinal function scores,and radiotherapy chemotherapy side effects scores and postoperative weight changes between two groups(P > 0.05).Conclusion:1.Low ligation of the inferior mesenteric vein is consistent with the principle of radical resection.2.Low ligation of the inferior mesenteric vein meets the requirements of rapid recovery after surgery(ERAS).