FLUSH AORTIC TIE VERSUS SELECTIVE PRESERVATION OF THE ASCENDING LEFT COLIC ARTERY IN LOW ANTERIOR RESECTION FOR RECTAL-CARCINOMA
FLUSH AORTIC TIE VERSUS SELECTIVE PRESERVATION OF THE ASCENDING LEFT COLIC ARTERY IN LOW ANTERIOR RESECTION FOR RECTAL-CARCINOMA
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DOI：
10.1002/bjs.1800790730
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发表时间：
1992-07-01
影响因子：
9.6
通讯作者：
HEALD, RJ
中科院分区：
文献类型：
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作者：
CORDER, AP;KARANJIA, ND;HEALD, RJ
在143例连续行低位前切除术、全直肠系膜切除和脾曲完全游离的患者中研究了两种结肠血管结扎方法的效果。选择性保留左结肠升动脉（ALCA）（n = 52）或进行冲洗主动脉结扎（n = 91）。在保护性结肠造口术的患者中，保留ALCA时放射性泄漏率为12%（n = 41），冲洗主动脉结扎时为10%（n = 60）（P > 0.95; 95%置信区间（c.i.）差异为-10%至+15%）。在那些没有结肠造口术的患者中，当保留ALCA时（n = 11）和当进行冲洗主动脉结扎时（n = 31）的临床泄漏率分别为9%和19%，没有显著差异（P > 0.10; 95% c.i.差异为-12%至+32%）。比例风险分析显示，血管结扎方法与肿瘤复发和死亡风险之间没有关联。吻合口漏率、肿瘤复发率和生存率与血管结扎方法无关。
The effects of two methods of colonic vascular ligation were studied in 143 consecutive patients who underwent low anterior resection with total mesorectal excision and full mobilization of the splenic flexure. Either the ascending left colic artery (ALCA) was selectively preserved (n = 52) or a flush aortic ligation was performed (n = 91). In those with a protective colostomy, the radiological leak rate was 12 per cent when the ALCA was preserved (n = 41) and 10 per cent when a flush aortic tie was performed (n = 60) (P > 0.95; 95 per cent confidence interval (c.i.) for difference -10 to +15 per cent). In those without a colostomy, the clinical leak rates of 9 per cent when the ALCA was preserved (n = 11) and 19 per cent when a flush aortic tie was performed (n = 31) were not significantly different (P > 0.10; 95 per cent c.i. for difference -12 to +32 per cent). Proportional hazards analysis showed no association between the method of vascular ligation and the risk of tumour recurrence and death. Anastomotic leak rates, tumour recurrence and survival were not related to the method of vascular ligation.