摘要
右半结肠癌D3根治术中可能发生肠系膜上神经丛的损伤,由于没有特异性症状,易被忽视。右半结肠的神经支配是双重的,包括外来神经系统和壁内神经系统,二者共同调节右半结肠的运动、吸收与分泌等功能。右半结肠癌D3根治术后发生腹泻、腹痛、排便次数增加等症状可能与术中淋巴结过度清扫而损伤肠系膜上神经丛有关。以术前肿瘤精准分期为依据、以神经纤维组织解剖为基础的淋巴结清扫可以有效避免神经损伤,减少术后肠道植物神经功能紊乱导致的症状。
Injury to the superior mesenteric plexus may occur during D3 resection of right colon cancer,which has not attracted the attention of surgeons and patients because there are no specific symptoms. The innervation of the right colon is dual, including the extrinsic nervous system and the intramural nervous system,which together regulate the movement,absorption and secretion of the right colon. The symptoms of diarrhea, abdominal pain, and increased defecation frequency after D3 resection of right colon cancer may be related to the excessive dissection of lymph nodes during the operation,resulting in damage to the superior mesenteric plexus. Moderate dissection based on accurate preoperative tumor staging and lymph node dissection based on nerve fiber tissue dissection can effectively avoid nerve damage and reduce postoperative symptoms caused by intestinal autonomic dysfunction.
作者
赵鑫
郭释琦
张宏
ZHAO Xin;GUO Shi-qi;ZHANG Hong(Department of General Surgery,Shengjing Hospital,China Medical University,Shenyang 110004,China)
出处
《中国实用外科杂志》
CAS
CSCD
北大核心
2022年第7期818-822,共5页
Chinese Journal of Practical Surgery
基金
辽宁省民生科技计划项目(No.2021JH2/10300053)。
