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[直肠癌手术中的脾曲游离]

[Splenic flexure mobilization in surgery for rectal cancer].

作者信息

Pryn P S, Polovinkin V V

机构信息

Research Institute - Ochapovsky Regional Clinical Hospital No.1 of the Ministry of Health of the Krasnodar Region, Krasnodar, Russia.

出版信息

Khirurgiia (Mosk). 2020(1):94-99. doi: 10.17116/hirurgia202001194.

Abstract

Nowadays, the issue of splenic flexure mobilization (SFM) in anterior and low anterior rectal resection for rectal cancer is still debatable. This stage is important because dissection results tension-free anastomosis and excision of specimen of enough length with adequate number of harvested lymph nodes. However, literature review confirmed the absence of agreement regarding reduced incidence of colorectal anastomotic leakage and improved long-term oncologic outcomes after SFM. Opinion about selective approach to this procedure is becoming more common. Therefore, randomized trials are necessary to determine a need for routine SFM or indications for selective approach to SFM in anterior rectal resection for rectal cancer.

摘要

如今,在直肠癌的前侧和低位前直肠切除术中,脾曲游离(SFM)问题仍存在争议。这一阶段很重要,因为解剖能实现无张力吻合,并切除足够长度的标本及获取足够数量的淋巴结。然而,文献综述证实,对于SFM后结直肠吻合口漏发生率降低以及长期肿瘤学结局改善方面,尚未达成共识。对于该手术采用选择性方法的观点正变得越来越普遍。因此,有必要进行随机试验,以确定在直肠癌前侧直肠切除术中是否需要常规进行SFM或选择性SFM的指征。

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