直肠癌侧方淋巴结清扫的关键问题探讨  

The discussion about key issues of lateral lymph nodes dissection for rectal cancer

作　　者：李绍堂[1] Shaotang Li(Department of Colorectal and Anal Surgery,the First Affiliated Hospital of Wenzhou Medical University,National Key Clinical Specialty(General Surgery),the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院国家临床重点专科(普通外科),温州医科大学附属第一医院结直肠肛门外科,325000

出　　处：《中华结直肠疾病电子杂志》2023年第3期190-195,共6页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：浙江省自然科学基金华东医药企业创新发展联合基金资助项目(LHDMY22H160002)。

摘　　要：近年来,由于手术技术的提高,我国开展直肠癌侧方淋巴结清扫(LLND)的单位也越来越多。然而,在侧方淋巴结转移的诊断标准、手术指征、患者的获益情况等方面还存在较大争议。本文就LLND的历史研究进行回顾,并围绕其分期争议、预防性行LLND的可行性、LLND与新辅助放化疗(nCRT)的关系,最佳手术适应证等关键问题进行综述,为后续研究提供参考。Recently, due to the improvement of surgical techniques, there are more and more units in China that carry out lateral lymph nodes dissection (LLND) for rectal cancers. However, there are still some controversies over the diagnostic criteria for lateral lymph nodes metastases, indications for surgery, whether the patient benefits and other aspects. This article reviewed the historical studies of lateral lymph nodes dissection, and also reviewed key issues such as the feasibility of prophylactic lateral lymph nodes dissection, the relationship between LLND and neoadjuvant chemoradiotherapy(nCRT), and the optimal surgical indications, provided a reference for follow-up studies.

关 键 词：直肠肿瘤 侧方淋巴结清扫 新辅助放化疗 全直肠系膜切除术 

分 类 号：R735.37[医药卫生—肿瘤]