低位直肠癌侧方淋巴结清扫的临床意义  

Significance of Lateral Lymph Nodes Sweeping in Lower Rectal Cancer

作　　者：董新舒[1] 李志高[1] 崔滨滨[1] 赵鹏[1] 刘明[1] 于志伟[1] 徐海涛[1] 

机构地区：[1]哈尔滨医科大学第三临床医学院腹部外科,哈尔滨150040

出　　处：《中国普外基础与临床杂志》2003年第2期103-105,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的　探讨侧方淋巴结清扫在低位直肠癌治疗中的意义。方法　回顾性分析 782例低位直肠癌以扩大淋巴结清扫的方法清扫直肠癌上方、侧方及部分下方的淋巴结。应用常规病理学的方法观察其侧方淋巴结转移的规律 ,并以直接方法统计侧方转移阳性病例的生存率。结果　①侧方淋巴结转移是腹膜返折以下直肠癌的转移途径 ,约占该部位直肠癌的 1 2 .5 % ;②侧方淋巴结转移易发生在低分化腺癌及粘液腺癌。肉眼见有浸润倾向者 ,侧方淋巴结转移与浸润深度有关 ;③侧方转移者 5年生存率为 42 .2 %。结论　腹膜返折以下的进展期直肠癌应该在上方淋巴结清扫的同时行侧方淋巴结清扫 ,可以避免转移淋巴结的残留 。Objective To study the significance of lateral lymph nodes sweeping in lower rectal cancer. Methods Routine pathological methods were used to detect the regularity of lateral lymph nodes metastasis and the survival rate of the patient. All the data was analysed by χ 2 test. Results ①Lateral lymph nodes metastasis was observed in 12.5% rectal cancer below the peritoneum,and it was the main lymph metastatic way. ②Low differented adenocarcinoma and mucous adenocarcinoma had more lateral lymph nodes metastasis than other types. Lateral lymph nodes metastasis was also related with invaded degree of invasion. ③The survival rate of the case with lateral lymph node metastasis was 42.2% .Conclusion Lateral lymph nodes should be swept in advanced rectal cancer to prevent remains of lymph nodes remained and increase the survival rate.

关 键 词：低位直肠癌 侧方淋巴结清扫 腹膜返折 治疗 回顾性分析 

分 类 号：R735.37[医药卫生—肿瘤]