低位直肠癌选择性侧方淋巴结清扫研究进展

doi:10.11904/j.issn.1002-3070.2021.01.014

摘要/Abstract

摘要： 盆腔侧方淋巴结(Lateral pelvic lymph node,LPLN)是低位直肠癌患者常见的局部转移部位,同时也是术后局部复发的主要部位,然而目前对于LPLN转移的治疗方案仍没有明确的定论。同时LPLN的转移应被看作是局部而不是全身,新辅助放化疗(Chemoradiotherapy,CRT)并不能替代手术清扫,侧方淋巴结清扫术(Lateral lymph node dissection,LLND)依然不可或缺。但由于LLND可能意味着更长的手术时间和更多的术后并发症,将其应用于所有低位直肠癌患者或许属于过度治疗,因此可受益患者的筛选显得尤为重要。LPLN的大小、短径缩小率、信号强度以及边缘特征均应加入筛选考量。

关键词: 低位直肠癌, 侧方淋巴结清扫, 新辅助治疗, 影像学

Abstract: Lateral pelvic lymph node(LPLN)is a common local site of metastasis in patients with low rectal cancer,and it is also the main site of postoperative local recurrence.However,there is still no clear conclusion about the treatment plan for LPLN metastasis.At the same time,the metastasis of LPLN should be regarded as local diseases rather than systemic.Neoadjuvant radiotherapy and chemotherapy(CRT)cannot replace surgical dissection.Lateral lymph node dissection(LLND)is still indispensable.However,since LLND may mean longer operative time and more postoperative complications,it may be over-treatment for all patients with low rectal cancer,so it is particularly important to select patients who can benefit.The size of the LPLN,the reduction ratio of the short path,the signal strength,and the edge characteristics should all be considered in the screening.

Key words: Low rectal cancer, Lateral lymph node dissection, Neoadjuvant therapy, Imaging

中图分类号:

R735.3⁺7

姚克非,张博淼(综述),崔滨滨(审校). 低位直肠癌选择性侧方淋巴结清扫研究进展[J]. 实用肿瘤学杂志, 2021, 35(1): 69-72.

YAO Kefei,ZHANG Bomiao,CUI Binbin. Research progress of selective lateral lymph node dissection in low rectal cancer[J]. Journal of Practical Oncology, 2021, 35(1): 69-72.

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