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中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (03) : 182 -189. doi: 10.3877/cma.j.issn.2095-3224.2023.03.002

侧方淋巴结清扫专栏

侧方淋巴结清扫术在直肠癌手术治疗中的研究进展
王文钦, 王培鑫, 周少飞()   
  1. 261100 青岛市市立医院普通外科
  • 收稿日期:2022-06-25 出版日期:2023-06-25
  • 通信作者: 周少飞
  • 基金资助:
    青岛市科技惠民示范专项-2022年生命健康新立项项目(22-3-7-smjk-4-nsh)

Research progress of lateral lymph node dissection in the surgical treatment of rectal cancer

Wenqin Wang, Peixin Wang, Shaofei Zhou()   

  1. Department of General Surgery, Qingdao Municipal Hospital, Qingdao 261100, China
  • Received:2022-06-25 Published:2023-06-25
  • Corresponding author: Shaofei Zhou
引用本文:

王文钦, 王培鑫, 周少飞. 侧方淋巴结清扫术在直肠癌手术治疗中的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(03): 182-189.

Wenqin Wang, Peixin Wang, Shaofei Zhou. Research progress of lateral lymph node dissection in the surgical treatment of rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(03): 182-189.

全直肠系膜切除术(TME)是中低位直肠癌手术治疗的金标准。相比之下,是否加做侧方淋巴结清扫(LLND),在世界范围内仍然存在较大的争议。本文通过回顾近年来关于直肠癌的LLND术相关的研究文献,总结目前LLND的研究现状,存在的争议、手术技巧及入路,以期全面探讨LLND术在直肠癌中的应用现状,亟待解决的争议,为以后LLND术在直肠癌中的精准应用提供理论支持和文献参考。

Total mesorectal excision (TME) is the gold standard for surgical treatment of rectal cancer. In contrast, whether to add lateral lymph node dissection (LLND) is still controversial worldwide. By reviewing the research literature related to lateral lymph node dissection for rectal cancer in recent years, this paper summarizes the current research status, controversies, surgical techniques and approaches of lateral lymph node dissection, in order to comprehensively discuss the application status of lateral lymph node dissection in rectal cancer, and the research worth in the future. To provide theoretical support and literature reference for the accurate application of lateral lymph node dissection in rectal cancer.

图1 直肠癌的淋巴结引流及侧方淋巴结的范围3(注释:红:肠旁淋巴结,蓝:中间淋巴结,黄:侧方淋巴结,白:比侧方淋巴结更接近中间的淋巴结)
表1 不同地区指南解读
图2 直肠癌中侧壁淋巴结的诊疗策略(图片来自文献[41])。注:nCRT:新辅助放化疗;TME:全直肠系膜切除;LLND:侧方淋巴结清扫术
图3 TEP手术入路56。3A:打孔位置;3B:手术入路间隙为腹膜外间隙
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