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目的:探讨保留左结肠动脉（LCA）联合经自然腔道取标本3D腹腔镜直肠癌根治术的临床疗效。方法:采用回顾性描述性研究方法。收集2018年12月至2019年12月河南省人民医院收治的186例直肠癌病人的临床病理资料；男120例，女66例；中位年龄为59岁，年龄范围为30~81岁。病人均行3D腹腔镜直肠癌根治术。观察指标：（1）手术及术后情况。（2）随访情况。采用门诊或电话方式进行随访，了解病人术后生存和肿瘤复发情况。随访时间截至2021年1月。正态分布的计量资料以n x±s表示，偏态分布的计量资料以n M（范围）表示。计数资料以绝对数和百分比表示。n 结果:（1）手术及术后情况：186例直肠癌病人均成功施行保留LCA联合经自然腔道取标本3D腹腔镜直肠癌根治术，手术时间为（123±24）min，术中出血量为（30±20）mL，淋巴结清扫数目为（15±7）枚。186例病人术后肛门排气时间为（2.3±0.7）d，术后进食半流质食物时间为（4.1±1.4）d，术后下床活动时间为（2.9±1.0）d，术后并发症发生率为8.06%（15/186）。186例病人术后住院时间为（6.6±1.9）d，治疗费用为（3.8±1.1）万元，术后病理学检查结果示低分化腺癌54例、中分化腺癌97例、高分化腺癌19例、黏液腺癌16例。（2）随访情况：186例直肠癌病人均获得随访，随访时间为13~24个月，中位随访时间为13个月。186例病人中，18例恶性肿瘤复发或转移，其中6例死亡；168例恢复良好。结论:保留LCA联合经自然腔道取标本3D腹腔镜直肠癌根治术安全、可行。“,”Objective:To investigate the clinical efficacy of three-dimensional (3D) laparos-copic radical resection of rectal cancer with left colic artery preservation and natural orfice specimen extraction surgery (NOSES).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 186 patients with rectal cancer who were admitted to Henan Provincial People\'s Hospital from December 2018 to December 2019 were colleted. There were 120 males and 66 females, aged from 30 to 81 years, with a median age of 59 years. Patients underwent 3D laparoscopic radical resection of rectal cancer. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect survival of patients and tumor recurrence up to January 2021. Measurement data with normal distribution were represented as n Mean±n SD, and measurement data with skewed distribution were represented as n M(range). Count data were described as absolute numbers and percentages.n Result:(1) Surgical situations: 186 patients with rectal cancer under-went 3D laparoscopic radical resection and postoperative with left colic artery preservation and NOSES. The operation time was (123±24)minutes, volume of intraoperative blood loss was (30±20)mL, the numer of lymph nodes dissected was 15±7. The time to postoperative first flatus, time to semiliquid food intake, time to postoperative out-of-bed activities were (2.3±0.7)days, (4.1±1.4)days, (2.9±1.0)days, respectively. The incidence of postoperative complications was 8.06%(15/186). The duration of postoperative hospital stay of 186 patients was (6.6±1.9)days and the treatment cost was (3.8±1.1) ten thousand yuan. Results of postoperative pathological examination showed 54 cases of low differentiated adenocarcinoma, 97 cases of moderate differentiated adenocarcinoma, 19 cases of high differentiated adenocarcinoma and 16 cases of mucinous adenocarcinoma. (2) Follow-up: 186 patients with rectal cancer were followed up for 13 to 24 months, with a median follow-up time of 13 months. During the follow-up, 18 patients had tumor recurrence or metastasis including 6 patients of death, 168 cases recovered well.Conclusion:3D laparoscopic radical resection of rectal cancer with left colic artery preservation and NOSES is safe and feasible.