中低位直肠癌侧方淋巴结清扫的临床应用进展  

Progress in the clinical application of lateral lymph node dissection for mid-low rectal cancer

作　　者：石磊 王举 SHI Lei;WANG Ju(Graduate School of Inner Mongolia Medical University,Inner Mongolia Hohhot 010000,China;Department of Gastrointestinal Surgery,Inner Mongolia People's Hospital,Inner Mongolia Hohhot 010017,China)

机构地区：[1]内蒙古医科大学研究生学院,内蒙古呼和浩特010000 [2]内蒙古自治区人民医院胃肠外科,内蒙古呼和浩特010017

出　　处：《现代肿瘤医学》2025年第5期870-875,共6页Journal of Modern Oncology

基　　金：内蒙古医学科学院公立医院科研联合基金(编号:2023GLLH0076)。

摘　　要：结直肠癌患者的预后与淋巴结转移密切相关,对于结直肠癌患者的治疗,不仅需要针对原发病灶的切除,还需要进行相关淋巴结的清扫,其中对于侧方淋巴结清扫(lateral lymph node dissection,LLND)学术界仍存在着一定的争议。有相关文献报道中低位直肠癌患者行侧方淋巴结的清扫会改善患者远期预后及增加总体生存率。然而,LLND的手术范围过大会引起手术创伤增大、手术时间延长、失血量增加、并发症发生率上升,不可避免地会对骨盆侧壁的血管和神经造成一些损伤。因此侧方淋巴结转移(lateral lymph node metastasis,LLNM)的诊断、规范化及个体化的治疗方案,对于保证肿瘤根治性、手术安全性、减少相关术后并发症、保护功能及改善预后起到了至关重要的作用。该文将对中低位直肠癌行侧方淋巴结清扫的临床应用现状及争议展开综述。The prognosis of colorectal cancer patients is closely related to lymph node metastasis.Treatment for colorectal cancer patients not only requires the resection of the primary lesion but also involves the clearance of related lymph nodes.Among these,lateral lymph node dissection(LLND)remains a subject of debate in the academic community.Some literature reports that LLND in patients with mid and low rectal cancer can improve long-term prognosis and increase overall survival rates.However,the extensive scope of LLND surgery can lead to increased surgical trauma,prolonged operation time,increased blood loss,and higher complication rates,inevitably causing some damage to the blood vessels and nerves of the pelvic sidewall.Therefore,the diagnosis,standardization,and individualized treatment of lateral lymph node metastasis(LLNM)play a crucial role in ensuring the radical cure of the tumor,surgical safety,reducing postoperative complications,preserving function,and improving prognosis.This article will review the current clinical application and controversies of lateral lymph node dissection in mid and low rectal cancer.

关 键 词：中低位直肠癌 侧方淋巴结 淋巴结清扫 

分 类 号：R735.37[医药卫生—肿瘤]