中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (06): 481-484.

• 专题笔谈 • 上一篇    下一篇

结肠癌D3手术规范化实施和关键点

林    锋,李    勇   

  1. 广东省人民医院胃肠外科,广东广州510060
  • 出版日期:2011-06-01 发布日期:2011-05-24

  • Online:2011-06-01 Published:2011-05-24

摘要:

要很好完成一台结肠癌手术,须强调肿瘤的根治性治疗,还要求有严格的无瘤观念。结肠癌D3手术具体实施的关键点有:无接触操作、血管根部断离、主淋巴结清扫、精确的间隙分离和足够的肠段切除。在结肠癌手术实施中,须坚持“由中心向周围,先淋巴后血管,先静脉后动脉”的原则。标准的D3 根治术可以降低术后复发率、提高5 年存活率,应该作为结肠癌常规的淋巴清扫方式,无论开腹或腹腔镜手术都应该遵循这一肿瘤根治原则,争取彻底根治机会。

关键词: 结肠肿瘤, 淋巴结清扫术

Abstract:

Standardization practice and key points of colon cancer D3 procedure        LIN Feng, LI Yong. Department of Gastrointestinal Surgery, Guangdong General Hospital,  Guangzhou510060, China
Corresponding  author :LIN Feng,E-mail:sylf33@21n.com
Abstract    It should emphasize the radical dissection of cancer and tumor-free principle to complete a good colon cancer surgery. Specific key points of D3 surgery include no-touch isolation technique, blood vessels break away from the root, the main lymph node dissection, accurate space separation and adequate bowel resection. Operator needs to adhere to the "from the center to the surrounding, the first lymphatic and then vessels, the first vein and then artery" principle. Hemicolectomy with D3 lymph node dissection is an effective way to reduce neoplasm recurrence without more operative complications and improve the 5-year survival rate, which should be a standard radical operation for open and laparoscopic surgery of colon cancer.

Key words: colon cancer , lymph node dissection