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中华普外科手术学杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 487 -491. doi: 10.3877/cma.j.issn.1674-3946.2022.05.004

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中国腹腔镜右半结肠癌根治淋巴结清扫范围的争议与思考
卢晓云1(), 王继伟1, 谢铭1,()   
  1. 1. 563000 贵州遵义,遵义医科大学附属医院普外科
  • 收稿日期:2022-06-27 出版日期:2022-10-26
  • 通信作者: 卢晓云, 谢铭

Controversy and reflection on the extent of laparoscopic radical lymph node dissection for colon cancer of the right hemicolectomy

Ming Xie1,(), Xiaoyun Lu1, Jiwei Wang1()   

  1. 1. Department of General Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou Province 563000, China
  • Received:2022-06-27 Published:2022-10-26
  • Corresponding author: Ming Xie, Jiwei Wang
  • Supported by:
    National Natural Science Foundation of China(81960105); Medical and health science and technology development research center of National Health Commission(WA2020RW12); Guizhou Science and Technology Foundation(2020-1Y301)
引用本文:

卢晓云, 王继伟, 谢铭. 中国腹腔镜右半结肠癌根治淋巴结清扫范围的争议与思考[J]. 中华普外科手术学杂志(电子版), 2022, 16(05): 487-491.

Ming Xie, Xiaoyun Lu, Jiwei Wang. Controversy and reflection on the extent of laparoscopic radical lymph node dissection for colon cancer of the right hemicolectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(05): 487-491.

右半结肠癌根治性手术治疗主要以全结肠系膜切除术(CME)和D3根治术为主,术式较为统一,但这两种术式还存在一定的争议。现主要是CME和D3根治术的淋巴结清扫范围争议较大,包括CME和D3根治术概念上、淋巴结清扫内侧界以及幽门下淋巴结是否常规清扫的争议。目前CME和D3淋巴结清扫内侧是热点话题,无论是支持以肠系膜上静脉左侧为淋巴结清扫内侧还是肠系膜上动脉左侧作为淋巴结清扫的内侧界,如今尚未形成统一规范,尚需大样本前瞻性多中心临床研究进一步证实。笔者通过回顾国内外研究现状,结合本中心实践经验,就腹腔镜右半结肠癌根治淋巴结清扫范围的争议进行讨论。

Total mesocolectomy(CME)and D3 radical surgery are the main surgical treatments for right colon cancer. The surgical methods are relatively uniform,but there are still some controversies between these two methods. At present,the scope of lymph node dissection is mainly controversial between CME and D3 radical resection,including the concept of CME and D3 radical resection,the medial boundary of CME and D3 lymph node dissection,and whether the subpyloric lymph node is routinely dissected. Currently,medial lymph node dissection of CME and D3 is a hot topic. Whether the left side of the superior mesenteric vein is used as the medial boundary of lymph node dissection or the left side of the superior mesenteric artery is used as the medial boundary of lymph node dissection,a unified standard has not been formed yet,which needs to be further confirmed by large-sample prospective multicenter clinical studies. The author reviewed the research status at home and abroad,combined with the practical experience of our center,and discussed the controversy of the scope of lymph node dissection in laparoscopic radical resection of right colon cancer.

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