左半结肠癌中央组淋巴结分布特点及外科清扫  

Research progress on the distribution patterns and surgical dissection of central lymph nodes in left-sided colon cancer

作　　者：鲍予頔 高志冬[1] Bao Yudi;Gao Zhidong(Gastrointestinal Surgery Department,Surgical Oncology Laboratory,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院胃肠外科外科肿瘤实验室,北京100044

出　　处：《中华胃肠外科杂志》2024年第9期914-918,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：北京大学人民医院研究与发展基金(RDJP2023-27)。

摘　　要：淋巴结转移是结直肠癌的主要转移途径之一,也是决定患者预后的重要因素。引流区域的淋巴结清扫,尤其是肿瘤相关供血动脉根部的中央组淋巴结清扫是外科手术技术的要点和难点。目前,关于左半结肠癌淋巴回流及中央组淋巴结(第253组淋巴结)的分布规律尚不清楚,中央组淋巴结清扫的必要性及范围也未达成统一共识,导致实际临床工作中不同医师对淋巴结清扫程度差异较大,且缺乏外科手术质控标准,影响术后治疗方案的选择及患者远期预后。同时,对于淋巴结回流及转移的研究,目前多以传统解剖学为基础,仅基于尸体解剖的现象描述、归纳和推测,不能满足外科手术清扫淋巴结时的个体化和精准化要求;而以功能解剖学为前提的术前及术中的淋巴结显像技术在结直肠癌患者中的应用也在进一步探索中。Lymphatic metastasis is one of the main pathways of colorectal cancer spread and also a crucial factor in patient long-term prognosis.Lymph node dissection in the possible tumor drainage area,particularly the central group of lymph nodes at the root of the tumor-associated supplying artery,is a key and challenging aspect of surgical techniques.Currently,the patterns of lymphatic drainage and the distribution of central lymph nodes in left-sided colon cancer are not well illustrated,and there is no consensus on the necessity and extent of central lymph node dissection.This has led to significant variability in the extent of lymph node dissection among different surgeons in clinical practice,a lack of quality control standards for surgical procedures,and impacts on postoperative treatment strategy and long-term outcomes.Moreover,current research on lymphatic drainage and metastasis is primarily based on traditional anatomy,whereas individualized,precise approaches to lymph node dissection have not been realized.The application of preoperative and intraoperative lymph node imaging techniques based on functional anatomy in colorectal cancer patients is still under exploration.

关 键 词：结肠肿瘤 左半 中央组淋巴结 D3清扫 功能解剖学 

分 类 号：R735.35[医药卫生—肿瘤]