摘要
在直肠癌的手术治疗中是否常规行侧方淋巴结清扫(LLND)仍存在争议,而LLND是否可以标准化操作是争议的焦点之一。相较于开放手术,腹腔镜手术的微创、放大效果以及深入盆腔的视野,被认为更适合实施LLND。熟悉直肠淋巴引流系统和盆腔自主神经的解剖对于腹腔镜直肠癌LLND的实施尤其是保护病人的性功能和排尿功能均非常重要。建议在直肠内侧、中间、外侧3个间隙内精确解剖以保留盆腔自主神经,并完成直肠癌淋巴结清扫。
Whether lateral lymph node dissection （LLND） is routinely performed in the surgical treatment of rectal cancer remains controversial, and whether LLND can be standardized is also one of the focuses of controversy. Compared with open surgery, laparoscopic surgery is considered more suitable for LLND because of its minimal invasiveness, magnifying effect and perfect pelvic vision. The knowledge of rectal lymphatic drainage system and pelvic autonomic nerve anatomy is important for the implementation of LLND in laparoscopic rectal cancer, especially for the preservation of sexual and urinary function. It is suggested to dissect accurately in the inner, intermediate and outer spaces around the rectum, topreserve the pelvic autonomic nerve and complete lateral lymph node dissection for rectal cancer.
作者
姚宏伟
张忠涛
YAO Hong-wei, ZHANG Zhong-tao(Department of General Surgery, Beijing Friendship Hospital, Capital Medical University ＆ National Clinical Research Center for Digestive Diseases, Beijing 100050, China)
出处
《中国实用外科杂志》
CSCD
北大核心
2018年第10期1148-1151,共4页
Chinese Journal of Practical Surgery
基金
国家科技支撑计划课题(No.2015BAI13809)
北京市医院管理局临床医学发展专项基金(No.ZYLX201504)
首都医科大学附属北京友谊医院科研启动基金(No.YYQDKT2016-5)
关键词
直肠癌
全直肠系膜切除
侧方淋巴结清扫
腹腔镜手术
rectal cancer
total mesorectal excision
laterallymph node dissection
laparoscopic surgery
