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空肠旁(No.206)和胃大弯(No.204)淋巴结转移的横结肠癌(InCLART 研究):一项多中心前瞻性观察研究方案。

Infrapyloric (No. 206) and greater curvature (No. 204) lymph node metastasis in adenocarcinoma located in the right half of the transverse colon (InCLART Study): protocol for a multicentre prospective observational study.

机构信息

Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai, People's Republic of China.

Shanghai Minimally Invasive Surgery Center, Shanghai, People's Republic of China.

出版信息

BMJ Open. 2023 Feb 21;13(2):e066981. doi: 10.1136/bmjopen-2022-066981.


DOI:10.1136/bmjopen-2022-066981
PMID:36810166
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9944796/
Abstract

INTRODUCTION: In the case of right-sided transverse colon cancer (RTCC) and hepatic flexure colon cancer (HFCC), there is a potential connection of lymph drainage between mesentery and greater omentum. However, most previous reports have been limited case series with No. 206 and No. 204 lymph node (LN) dissection for RTCC and HFCC. METHODS AND ANALYSIS: The InCLART Study is a prospective observational study aiming to enrol 427 patients with RTCC and HFCC treated at 21 high-volume institutions in China. The prevalence of infrapyloric (No. 206) and greater curvature (No. 204) LN metastasis and short-term outcomes will be investigated in a consecutive series of patients with T2 or deeper invasion RTCC or HFCC, following the principle of complete mesocolic excision with central vascular ligation. Primary endpoints were performed to identify the prevalence of No. 206 and No. 204 LN metastasis. Secondary analyses will be used to estimate prognostic outcomes, intraoperative and postoperative complications, the consistency of preoperative evaluation and postoperative pathological results of LN metastasis. ETHICS AND DISSEMINATION: Ethical approval for the study has been granted by the Ruijin Hospital Ethics Committee (approval number: 2019-081) and has been or will be approved successively by each participating centre's Research Ethics Board. The findings will be disseminated in peer-reviewed publications. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03936530; https://clinicaltrials.gov/ct2/show/NCT03936530).

摘要

简介:在右半横结肠癌(RTCC)和肝曲结肠癌(HFCC)的情况下,肠系膜和大网膜之间可能存在淋巴引流的联系。然而,大多数先前的报告仅限于病例系列,对 RTCC 和 HFCC 进行了第 206 号和第 204 号淋巴结(LN)清扫。

方法和分析:InCLART 研究是一项前瞻性观察性研究,旨在在中国 21 家高容量机构中招募 427 例接受治疗的 RTCC 和 HFCC 患者。将按照完整结肠系膜切除伴中央血管结扎的原则,对 T2 或更深侵袭性 RTCC 或 HFCC 的连续患者系列,调查胰下(第 206 号)和胃大弯(第 204 号)LN 转移的发生率以及短期结果。主要终点是确定第 206 号和第 204 号 LN 转移的发生率。二次分析将用于估计预后结果、术中术后并发症、术前评估与术后 LN 转移的病理结果的一致性。

伦理与传播:该研究已获得瑞金医院伦理委员会的批准(批准号:2019-081),并将陆续获得每个参与中心的研究伦理委员会的批准。研究结果将在同行评议的出版物中发表。

试验注册编号:ClinicalTrials.gov 注册(NCT03936530;https://clinicaltrials.gov/ct2/show/NCT03936530)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/c59f2354879c/bmjopen-2022-066981f07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/cc535210b47f/bmjopen-2022-066981f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/1e7e98da6caa/bmjopen-2022-066981f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/40121a6fb675/bmjopen-2022-066981f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/3126c488ad74/bmjopen-2022-066981f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/cb57a4317786/bmjopen-2022-066981f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/30b4b2fd30cd/bmjopen-2022-066981f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/c59f2354879c/bmjopen-2022-066981f07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/cc535210b47f/bmjopen-2022-066981f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/1e7e98da6caa/bmjopen-2022-066981f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/40121a6fb675/bmjopen-2022-066981f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/3126c488ad74/bmjopen-2022-066981f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/cb57a4317786/bmjopen-2022-066981f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/30b4b2fd30cd/bmjopen-2022-066981f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afa/9944796/c59f2354879c/bmjopen-2022-066981f07.jpg

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引用本文的文献

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A modified combined approach in laparoscopic right hemicolectomy for right-sided colon based on surgical trunk orientation: a case of a new surgical technique.

J Gastrointest Oncol. 2025-6-30

本文引用的文献

[1]
Infrapyloric and gastroepiploic node dissection for hepatic flexure and transverse colon cancer: A systematic review.

Eur J Surg Oncol. 2022-4

[2]
Clinical analysis of metastatic characteristics of infrapyloric lymph nodes (No.206) and terminal ileum lymph nodes in patients with right colon cancer.

World J Surg Oncol. 2021-10-22

[3]
Update in version 2021 of CSCO guidelines for colorectal cancer from version 2020.

Chin J Cancer Res. 2021-6-30

[4]
Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.

J Natl Compr Canc Netw. 2021-3-2

[5]
Infrapyloric lymph node dissection in right hemicolectomy for colon cancer: Should prophylactic resection be recommended?

J Surg Oncol. 2021-5

[6]
Incidence of and Risk Factors for Gastroepiploic Lymph Node Involvement in Patients with Cancer of the Transverse Colon Including the Hepatic Flexure.

World J Surg. 2021-5

[7]
Gastrocolic ligament lymph-node dissection may increase the incidence of delayed gastric emptying after colon cancer surgery with D3 lymphadenectomy.

Surg Today. 2021-6

[8]
Feasibility and Safety of Laparoscopic Complete Mesocolic Excision (CME) for Right-sided Colon Cancer: Short-term Outcomes. A Randomized Clinical Study.

Ann Surg. 2021-7-1

[9]
Gastrocolic Ligament Lymph Node Dissection for Transverse Colon and Hepatic Flexure Colon Cancer: Risk of Nodal Metastases and Complications in a Large-Volume Center.

J Gastrointest Surg. 2020-11

[10]
Does transverse colon cancer spread to the extramesocolic lymph node stations?

Acta Chir Belg. 2021-4

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