摘要
结直肠癌是一种常见的消化道恶性肿瘤,其中,右半结肠切除联合区域淋巴结清扫是右半结肠癌的标准术式。然而目前对右半结肠癌的淋巴结清扫范围尚未达成统一,欧美指南推荐的全结肠系膜切除(CME)合并中央血管结扎术(CVL),并未对淋巴结清扫范围有明确界定,而日本指南提出的D3手术风险较大,似乎有过度治疗之嫌。国内右半结肠癌手术推崇欧美的CME原则,而淋巴结清扫却效仿日本D2/D3的手术范围,至今尚未形成统一规范。本文将就右半结肠癌淋巴转移特点,和D2/D3淋巴结清扫的利弊做一综述。
Colorectal cancer is one of the most common malignant digestive tumors,of which colectomy combined with regional lymphadenectomy is the standard treatment.However,the extent of lymphadenectomy has not reached a consensus.The concept of complete mesocolic excision(CME)with central vascular ligation(CVL)proposed by European surgeons has not made a clear definition about the margin of lymph node excision,while D3 lymphadenectomy proposed by Japanese guideline proved to have more perioperative risks,which seems some kind of over-treatment.In our country,right hemicolectomy standard has not been established,surgeons perform right colectomy following the CME strategy and lymphadenectomy following D2/D3 excision standard.So,we reviewed the characteristics of lymph node metastasis of right colon cancer,and the advantages and disadvantages of D2/D3 lymphadenectomy.
作者
刘赛靓
周勇
俞旻皓
钟鸣
Liu Sailiang;Zhou Yong;Yu Minhao;Zhong Ming(Department of Colorectal Surgery,Renji Hospital,School of Medicine,Jiaotong University,Shanghai 200127,China;Department of Surgery,Jiading Hospital of Traditional Chinese Medicine,Shanghai 201800,China)
出处
《中华结直肠疾病电子杂志》
2020年第5期507-511,共5页
Chinese Journal of Colorectal Diseases(Electronic Edition)
基金
国家自然科学基金(No.81702300,No.81873555)。
关键词
结肠肿瘤
右半结肠癌
淋巴结清扫范围
D2手术
D3手术
Colonic neoplasms
Right colon cancer
The extent of lymphadenectomy
D2 lymphadenectomy
D3 lymphadenectomy
