摘要目的 探讨结肠脾曲及乙状结肠解剖学变异对降结肠癌根治术后吻合方式的影响.方法 回顾性分析河南省肿瘤医院普外科2004年3月至2011年4月76例因降结肠癌行左半结肠切除手术患者的临床病理资料,统计结肠脾曲及乙状结肠的解剖学变异类型,分析其对根治术后结肠吻合方式的影响.结果 纳入76例患者,结肠脾曲为系膜型者55例,游离型者7例,粘连型者14例；乙状结肠为常见型(Ⅰ型)61例,变异型15例(Ⅱ型7例、Ⅲ型6例、Ⅳ型2例)；结肠脾曲分型系膜型43例(78.2％)、游离型5例(71.4％)、粘连型9例(64.3％)行原位结肠吻合,各型比较差异无统计学意义(P＞0.05),而乙状结肠系膜分型中Ⅰ型56例(91.8％)行原位结肠吻合,与Ⅱ型[1例(14.3％)]、Ⅲ型或Ⅳ型(0例)差异有统计学意义(P＜0.05).结论 重视乙状结肠变异类型,有助于降结肠癌根治术后选择合理的吻合方式.

abstractsObjective To explore the effects of splenic flexure and sigmoid colon variation on anastomosis after left colectomy.Methods The clinical data of 76 descending colon patients were collected retrospectively from March 2004 to April 2011 at our hospital.Statistical analysis was performed for the types of splenic flexure and sigmoid colon with regards to the choice of anastomosis.Results There were mesenteric type (n ＝55),mobile type (n ＝7) and adhesive type (n ＝ 14) for splenic flexure.And among 61 regular types,15 were of variable type for sigmoid colon variation.There was significant difference of anastomosis between the types of sigmoid colon variation [43(78.2％ ) vs 5(71.4％ ) vs 9(64.3％ ),P＞0.05] while no significant difference existed between the types of splenic flexure [ Ⅰ type 56(91.8％ ) vs Ⅱ type 1 ( 14.3％ ),Ⅲ or V type 0,P ＜ 0.05 ].Conclusion A clinician should pay more attention to the types of sigmoid colon variation.And it helps to select the right approach of anastomosis after left colectomy.