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[结直肠癌区域淋巴结复发。基于血管造影结果对病因及治疗的思考]

[Regional lymph node recurrence of colorectal cancer. Considerations of etiology and therapy based on angiography findings].

作者信息

Hohenberger P, Schlag P, Kretzschmar U, Herfarth C

机构信息

Chirurgische Klinik und Poliklinik Universität Heidelberg.

出版信息

Chirurg. 1991 Feb;62(2):110-6.

PMID:2044417
Abstract

Within a group of 101 patients treated for locally recurrent colorectal cancer 10 of them presented with a recurrence located in the lymphnodes of the primary tumor bed. This "pseudo-recurrence" shows some typical findings as elevated CEA serum levels in asymptomatic patients, and intact anastomosis endoscopically. However, angiography reveals the presence of the inferior mesenteric artery and it branches left behind at operation for the primary tumor. Furthermore, endoluminal ultrasound may be able to detect these situations. Both investigations are a must in patients following resection of a colorectal primary tumor of the left hemicolon or rectum being suspicious for a locoregional recurrence. Detection of a lymphnode recurrence may be of value in planning for a reintervention as it helps to select patients with a better chance for a curative surgical approach.

摘要

在一组101例接受局部复发性结直肠癌治疗的患者中,有10例复发位于原发肿瘤床的淋巴结。这种“假性复发”表现出一些典型特征,如无症状患者血清癌胚抗原(CEA)水平升高,且内镜检查吻合口完整。然而,血管造影显示存在肠系膜下动脉及其在原发性肿瘤手术时遗留的分支。此外,腔内超声可能能够检测到这些情况。对于左半结肠或直肠原发性肿瘤切除术后怀疑局部区域复发的患者,这两项检查都是必需的。检测淋巴结复发对于规划再次干预可能有价值,因为它有助于选择有更好机会接受根治性手术的患者。

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