Kanemitsu Y, Hirai T, Komori K, Kato T
Department of Gastroenterological Surgery, Aichi Cancer Centre, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
Br J Surg. 2006 May;93(5):609-15. doi: 10.1002/bjs.5327.
The aim of this study was to assess the impact of inferior mesenteric artery (IMA) root nodal dissection before high ligation of the artery on survival in patients with sigmoid colon or rectal cancer.
Data on 1188 consecutive patients who underwent resection for sigmoid colon or rectal cancer, with high ligation of the IMA, were identified from a prospective database (April 1965 to December 1999). Survival of patients with involvement of nodes along the IMA proximal to the origin of the left colic artery (root nodes, station 253) through the bifurcation of the superior rectal artery (trunk nodes, station 252) was determined.
Twenty patients (1.7 per cent) had metastatic involvement of station 253 lymph nodes and 99 (8.3 per cent) had metastases to station 252. The 5- and 10-year survival rates of patients with metastases to station 253 were 40 and 21 per cent, and those for patients with metastases to station 252 were 50 and 35 per cent, respectively.
High ligation of the IMA allows curative resection and long-term survival in patients with cancer of the sigmoid colon or rectum and nodal metastases at the origin of the IMA.
本研究旨在评估肠系膜下动脉（IMA）根部淋巴结清扫术在该动脉高位结扎之前对乙状结肠癌或直肠癌患者生存率的影响。
从一个前瞻性数据库（1965年4月至1999年12月）中识别出1188例连续接受乙状结肠癌或直肠癌切除术并进行IMA高位结扎的患者的数据。确定了从左结肠动脉起始部近端（根部淋巴结，第253站）至直肠上动脉分叉处（主干淋巴结，第252站）沿IMA有淋巴结受累患者的生存率。
20例患者（1.7%）有第253站淋巴结转移，99例（8.3%）有第252站转移。第253站转移患者的5年和10年生存率分别为40%和21%，第252站转移患者的5年和10年生存率分别为50%和35%。
IMA高位结扎可使乙状结肠癌或直肠癌且IMA起始部有淋巴结转移的患者实现根治性切除并获得长期生存。
