中低位直肠癌新辅助治疗后侧方淋巴结清扫的应用现状分析  

Analysis of Application Status of Lateral Lymph Node Dissection after Neoadjuvant Treatment of Low and Middle Rectal Cancer

作　　者：赵哲明[1] 陈静[1] 戴冬秋[1] ZHAO Zheming;CHEN Jing;DAI Dongqiu(Department of Gastrointestinal Surgery,the Fourth Affiliated Hospital of China Medical University,Shenyang 110032,China)

机构地区：[1]中国医科大学附属第四医院胃肠外科,沈阳110032

出　　处：《医学综述》2020年第15期2970-2974,2981,共6页Medical Recapitulate

摘　　要：直肠癌是最常见的恶性肿瘤之一,淋巴结转移是其主要转移途径,手术作为直肠癌的重要治疗方式,术中淋巴结清扫范围直接影响患者术后的局部复发率及生存期。侧方淋巴结转移是中低位进展期直肠癌的转移途径之一,是中低位直肠癌复发的重要原因。中低位直肠癌的治疗方式尚存争议,新辅助放化疗联合全直肠系膜切除术后仍存在一定的盆腔复发率,新辅助放化疗前后综合评估侧方淋巴结大小及反应性,选择性实施侧方淋巴结清扫可进一步降低复发风险,但术后排尿和性功能障碍的发病率较高,因而应严格控制行侧方淋巴结清扫的条件。Rectal cancer is one of the most common malignant tumors,and lymph node metastasis is the main metastasis pathway.Surgery is an important treatment for rectal cancer,and the extent of lymph node dissection directly affects the local recurrence rate and survival time.Lateral lymph node metastasis is one of the metastatic pathways of middle and low advanced rectal cancer,and it is an important cause of the recurrence.The treatment is still controversial,as neoadjuvant chemoradiation joint after total mesorectum excision still has a certain pelvic recurrence rate.Comprehensive evaluation of the lateral lymph node size and its reactivity before and after neoadjuvant chemoradiation,and selective enforcement of lateral lymph node dissection can further reduce the risk of recurrence,but the incidence of postoperative micturition and sexual dysfunction is higher,therefore the lateral lymph node dissection condition should be strictly controlled.

关 键 词：中低位直肠癌 新辅助治疗 侧方淋巴结清扫 复发率 生存率 

分 类 号：R735.37[医药卫生—肿瘤]