Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, University of Sydney, St Leonards, NSW 2065, Australia.
Eur J Surg Oncol. 2013 Jun;39(6):662-5. doi: 10.1016/j.ejso.2013.03.001. Epub 2013 Mar 23.
While colorectal cancer is increasingly common in western populations, anatomical concepts regarding the anatomy of resection have remained static. In attempting to maximise the chance of surgical cure, surgeons and pathologists are now focussing upon the quality of oncological resection. Amongst pathological indices of interest, lymph node yield and the apical lymph node specifically are increasingly being shown to be reliable markers of the adequacy of oncologic resection. However, the position of the apical node in particular, is highly subjective and may not always correlate with the anatomical boundaries ultimately defining resection. We argue that the present definition of the apical lymph node is overly subjective and requires re-defining based on fixed anatomical landmarks. We propose that this new definition include a block of tissue inferolateral to the Trunk of Henle (the anatomical apical lymph node compartment).
虽然结直肠癌在西方人群中越来越常见，但有关切除解剖的解剖学概念仍然保持不变。为了最大限度地提高手术治愈的机会，外科医生和病理学家现在专注于肿瘤切除的质量。在感兴趣的病理指标中，淋巴结产量和特别是顶淋巴结越来越被证明是肿瘤切除充分性的可靠标志物。然而，特别是顶淋巴结的位置，具有高度的主观性，并不总是与最终定义切除的解剖学边界相关。我们认为，目前对顶淋巴结的定义过于主观，需要基于固定的解剖学标志重新定义。我们建议，这个新定义应包括位于 Henle 干（解剖顶淋巴结区）下外侧的组织块。
