关键词: 直肠癌前切除术(Dixon术), 乙状结肠系膜, 肠系膜下动脉, 三维重建

Abstract: Objective To explore the application value of low ligation of inferior mesenteric artery(IMA)in laparoscopic Dixon of nonⅠsigmoid colon mesangial(SMC). Methods Seventy-one cases of nonⅠSMC rectal cancer patients who evaluated for feasibility of laparoscopic Dixon in the Department of Gastrointestinal Surgery Affiliated Tumor Hospital of Xinjiang Medical University from September 2017 to July 2018 were selected in this study,and they were randomly divided into two groups:the group of left colic artery reserved(low ligation group)and the group of left colic artery not retained(high ligation group).A three-dimensional computed tomography angiography of inferior mesenteric artery was obtained in all patients to guide the intraoperative accurate ligation of vessels.The baseline data,intraoperative and postoperative quantitative parameters of the two groups were compared. Results Three patients in the group of left colic artery reserved were forced to turn to high ligation for it could not meet the requirement of anastomosis.The low ligation group showed significant difference to the high ligation group on operation time[170(160,180)vs.180(170,210)](P=0.026),but there was no significant difference in the aspect of gender,age,BMI,distance between tumor and anal border,TNM stage,intraoperative blood loss,the splenic free rate,prophylactic stoma rate,Length of specimen,maximum diameter of tumor,tissue typing,total lymph node count,D3 lymph node count,postoperative first exhaust time,days in hospital since surgery and anastomotic fistula rate(P＞0.05). Conclusion Low ligation of inferior mesenteric artery can shorten the operation time and significantly lessen unplanned bowel length and reduce postoperative risk of anastomotic leakage.All of these are beneficial to patients' postoperative recovery and have important clinical guiding value.

Key words: Dixon, Sigmoid colon mesangial, Inferior mesenteric artery, Three-dimensional reconstruction