中国实用外科杂志

中国实用外科杂志 ›› 2006, Vol. 26 ›› Issue (12): 1-959.

• 论著 •    

直肠癌术中从根部结扎肠系膜下动脉临床意义探讨

曹志新，徐向上，杨传永   

  1. 华中科技大学同济医学院附属同济医院胃肠外科中心，湖北武汉430030
  • 收稿日期:2006-09-10 修回日期:2006-10-08 出版日期:2007-01-17 发布日期:2007-01-17

Effect of high ligation of inferior mesenteric artery in rectal cancer surgery.

Cao Zhixin,Xu Xiangshang,Yang Chuanyong.   

  1. Gastrointestinal Surgery Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China
  • Received:2006-09-10 Revised:2006-10-08 Online:2007-01-17 Published:2007-01-17

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摘要：

目的:探讨直肠癌术中从根部结扎肠系膜下动脉的临床意义。方法:回顾性分析华中科技大学同济医学院附属同济医院2000年1月至2005年12月499例肠系膜下动脉根部结扎的直肠癌临床病理资料。结果:肠系膜下动脉根部淋巴结转移率为14.4%。肿瘤分化程度为低分化腺癌、黏液腺癌或印戒细胞癌，肿瘤浸润深度达到pT3和pT4的直肠癌病人，其肠系膜下动脉根部淋巴结转移率较高。结论:低分化腺癌、黏液腺癌或印戒细胞癌，浸润深度达到pT3和pT4时，直肠癌肠系膜下动脉根部淋巴结转移率较高，在行直肠癌根治手术时应行肠系膜下动脉根部结扎以提高5年存活率。

关键词: 直肠肿瘤, 肠系膜下动脉, 淋巴转移

Abstract:

Objective:To evaluate the clinical effect of high ligation of inferior mesenteric artery in rectal cancer surgery. Methods:Four hundreds and ninetynine patients with rectal cancer underwent high ligation of inferior mesenteric artery in Tongji hospital of Tongji Medical College,Huazhong University of Science and Technology between January 2000 and December 2005 were reviewed retrospectively. Results:The metastatic rate of the lymph nodes at the root of the inferior mesenteric artery was 14.4%.The inferior mesenteric artery root nodal metastasis occurred more frequently with low differentiation adenocarcinoma,mucous adenocarcinoma,signetring cell cancer and pT3 or pT4 stage rectal cancer. Conclusion:In radical surgery of rectal cancer, the high ligation of the inferior mesenteric artery should be performed for the following risk factors:patients with low differentiation adenocarcinoma,mucous adenocarcinoma,signetring cell cancer and pT3 or pT4 stage rectal cancer.The high ligation of the inferior mesenteric artery can improve 5-year survival rate.

Key words: Rectal cancer, Inferior mesenteric artery, Lymphatic metastasis