直肠癌手术中使用肠系膜下动脉高位结扎的指征。通过清扫法检查淋巴结转移情况。
Indication for using high ligation of the inferior mesenteric artery in rectal cancer surgery. Examination of nodal metastases by the clearing method.
作者信息
Hida J, Yasutomi M, Maruyama T, Fujimoto K, Nakajima A, Uchida T, Wakano T, Tokoro T, Kubo R, Shindo K
机构信息
First Department of Surgery, Kinki University School of Medicine, Osaka, Japan.
出版信息
Dis Colon Rectum. 1998 Aug;41(8):984-7; discussion 987-91. doi: 10.1007/BF02237385.
PURPOSE
In surgery for rectal cancer, it is unclear whether the inferior mesenteric artery should be ligated at a high or low position. The study contained herein was undertaken to clarify the indications for high ligation of the inferior mesenteric artery.
METHODS
Subjects included 198 patients with rectal cancer who underwent resection with high ligation of the inferior mesenteric artery. Nodal metastases were examined by the clearing methods.
RESULTS
The incidence of metastases to the lymph nodes surrounding the origin of the inferior mesenteric artery (root nodes) was 8.6 percent. Inferior mesenteric artery root nodal metastases occurred more frequently with pT3 and pT4 cancer. The five-year survival rate in patients with inferior mesenteric artery root nodal metastases was 38.5 percent; this rate was significantly lower than in those without inferior mesenteric artery root nodal metastases (73.4 percent).
CONCLUSIONS
Although the five-year survival rate in patients with inferior mesenteric artery root nodal metastases was lower than in those without metastases, inferior mesenteric artery root nodal dissection should be performed after high ligation of the inferior mesenteric artery for patients with pT3 and pT4 cancers.
目的
在直肠癌手术中，肠系膜下动脉应高位还是低位结扎尚不清楚。本文开展的这项研究旨在明确肠系膜下动脉高位结扎的指征。
方法
研究对象包括198例行肠系膜下动脉高位结扎切除术的直肠癌患者。采用清扫法检查淋巴结转移情况。
结果
肠系膜下动脉起始部周围淋巴结（根部淋巴结）转移发生率为8.6%。pT3和pT4期癌症患者中，肠系膜下动脉根部淋巴结转移更为常见。肠系膜下动脉根部淋巴结转移患者的五年生存率为38.5%；该比率显著低于无肠系膜下动脉根部淋巴结转移的患者（73.4%）。
结论
尽管肠系膜下动脉根部淋巴结转移患者的五年生存率低于无转移患者，但对于pT3和pT4期癌症患者，应在肠系膜下动脉高位结扎后进行肠系膜下动脉根部淋巴结清扫。
Zotero 插件