进展期低位直肠癌侧方淋巴转移个体化治疗新进展  

New Progress in Individualized Treatment of Lateral Lymphoid Metastasis of Advanced Low Rectal Cancer

作　　者：边士昌[1] 王维生 BIAN Shichang;WANG Weisheng(Department of Colorectal Anorectal Surgery,Tianjin Fourth Central Hospital,Tianjin 300140,China)

机构地区：[1]天津市第四中心医院结直肠肛门外科,天津300140

出　　处：《继续医学教育》2021年第2期85-87,共3页Continuing Medical Education

摘　　要：直肠癌在世界范围内是一个重大的公共卫生问题。自20世纪80年代全直肠系膜切除(total mesorectal excision,TME)概念的出现,它一直是治疗中低位直肠肿瘤的黄金标准,因为此术式彻底切除了位于直肠系膜内的淋巴结,确实改善了病理和肿瘤学结果。但是当肿瘤扩散到侧方淋巴结时,欧美和日本的学者做法不同。欧美医师将侧方淋巴结转移定义为肿瘤远处转移,需要新辅助放化疗;而日本学者认为局部病变,无论是否行新辅助放化疗,侧方淋巴结清扫术(lateral lymph node dissection,LLND)是必要的。回顾了当前关于直肠癌侧方淋巴结的文献,最终是为减少并发症,降低复发率,提高患者生存率。Rectal cancer constitutes a major public health issue.Total mesorectal excision has remained the gold standard treatment for mid and low rectal tumors since its introduction in the late 1980s.Removal of all lymph nodes located in the mesorectum has indeed improved pathological and oncological outcomes.However,when cancer spreads to the lateral lymph nodes,Western and Japanese practices differ.Western scholars believe that lateral lymph node metastasis is distant metastasis of the tumor,which requires neoadjuvant radiotherapy and chemotherapy,while Japanese scholars believe that local lesions,whether neoadjuvant radiotherapy and chemotherapy or not,lateral lymph node dissection(LLND)is necessary.We reviewed the current literature on lateral lymph nodes of rectal cancer in order to improve the treatment and prognosis of patients with middle and low rectal cancer.

关 键 词：直肠癌 侧方淋巴结转移 侧方淋巴结清扫 

分 类 号：R735[医药卫生—肿瘤]