直肠癌侧方淋巴结清扫争议与共识  

Controversy and consensus on lateral lymph node dissection for rectal cancer

作　　者：周建平[1] 刘刚[1] 董明[1] ZHOU Jian-ping;LIU Gang;DONG Ming(Department of Gastrointestinal Surgery,The First Hospital of China Medical University,Shenyang110001,China)

机构地区：[1]中国医科大学附属第一医院胃肠外科

出　　处：《中国实用外科杂志》2019年第7期682-686,共5页Chinese Journal of Practical Surgery

摘　　要：侧方淋巴结转移是低位直肠癌病人诊治中常见问题;而东西方学者对于中低位直肠癌TME手术是否结合侧方淋巴结清扫仍然存在争议;腹腔镜或机器人辅助侧方淋巴结清扫与开放手术对比的相关研究仍停留在回顾性分析;需要前瞻性队列研究进一步证实各自的优越性;新辅助放化疗能否代替侧方淋巴结清扫目前尚无定论;其与东西方学者对侧方淋巴结转移属于局部还是属于全身的认知有关。Lateral lymph node metastasis is a common problem in the diagnosis and treatment of patients with low rectal cancer. Eastern and western scholars are still controversial about the combination of lateral lymph node dissection in TME surgery for middle and low rectal cancer. The study of correlation between laparoscopic or robot-assisted lateral lymph node dissection and open surgery is still in retrospective analysis;and prospective cohort studies are needed to further confirm their superiority. Whether neoadjuvant radiochemotherapy can replace lateral lymph node dissection is still inconclusive;and it is related to the cognition that the lateral lymph node metastasis belongs to the regional or the systemic metastasis of the oriental and occidental scholars.

关 键 词：直肠癌 侧方淋巴结清扫 腹腔镜 机器人 放化 

分 类 号：R6[医药卫生—外科学]