Ackerman N B
Surgery. 1976 Sep;80(3):312-6.
Because veins and lymphatics constitute the major pathways for metastatic spread of cancer of the colon, the dynamics of venous and lymphatic outflow from the intestine were studied in dogs with use of electromagnetic flowmeter for the veins and cannulation and gravimetric measurement for the lymph. Venour ligation produced sixfold increases in lymph flow. Venous outflow doubled when adjacent veins were occluded but dropped when marginal vessels were ligated. Simultaneous ligation of arteries and veins caused significant decreases in lymph outflow (to 26% of control), but if arterial collaterals remained intact, lymph flow rose more than twofold. Venous outflow doubled after simultaneous occulusion of adjacent arteries and veins, but dropped as marginal vessels were ligated. Arterial ligation alone was most satisfactory, resulting in significant rapid decreases in lymph flow (to 32% of control) and venous flow (to 5% of control. As suggested by these studies, primary arterial ligation, followed by marginal vessel ligation, is being used as a modification of the "no touch" technique for cancer of the colon.
由于静脉和淋巴管是结肠癌转移扩散的主要途径，因此利用电磁流量计测量静脉以及插管和重量法测量淋巴，对犬的肠道静脉和淋巴流出动力学进行了研究。静脉结扎使淋巴流量增加了六倍。当相邻静脉被阻断时，静脉流出量增加一倍，但当边缘血管被结扎时则下降。动脉和静脉同时结扎导致淋巴流出量显著减少（降至对照的26%），但如果动脉侧支保持完整，淋巴流量则增加两倍多。相邻动脉和静脉同时闭塞后，静脉流出量增加一倍，但随着边缘血管被结扎而下降。单独进行动脉结扎最为理想，可使淋巴流量（降至对照的32%）和静脉流量（降至对照的5%）迅速显著减少。正如这些研究所表明的，先进行主要动脉结扎，随后进行边缘血管结扎，正被用作结肠癌“非接触”技术的一种改良方法。
