摘要
经过不断探索,腹腔镜右半结肠癌根治术已从D2、D3、完整结肠系膜切除(CME),发展至目前国内较为广泛认可的基于膜解剖的D3+CME手术。虽然手术技术日趋成熟,但由于解剖层次复杂、血管解剖变异多,D3+CME手术难度仍然较大,技术要求较高。在手术过程中的一些细节问题,如手术入路的选择、淋巴结清扫内侧界的界定、关键血管解剖变异的认识以及吻合方式的选择,成为当前争论的焦点。临床医师应重视手术的安全性,关注手术难点,不断探讨和解决相关争议,以促使我国腹腔镜右半结肠癌D3根治术更加规范、精准和安全。
Laparoscopic radical resection of right colon cancer has experienced continuous exploration from D2,D3,and complete mesocolic excision(CME)to D3+CME surgery based on membrane anatomy,which is widely recognized in China.Although the surgical technique is becoming more and more mature,due to the complex anatomy of right colon cancer and the variation of vascular anatomy,the operation is still difficult and technically demanding.In terms of some details in the surgical process,such as the choice of surgical approach,the definition of the medial border of lymph node resection,the understanding of key vascular anatomical variations,and the choice of anastomosis methods,have become the focus of current debate.Clinicians should pay attention to the safety and difficulties of surgery and constantly discuss and resolve relevant disputes in order to make laparoscopic D3 radical resection of right colon cancer in our country more standardized,accurate,and safe.
作者
王振宁
邢亚楠
王喆
胡兆亮
WANG Zhen-ning;XING Ya-nan;WANG Zhe(Department of Surgical Oncology and General Surgery,the First Affiliated Hospital of China Medical University,Shenyang 10001,China)
出处
《中国实用外科杂志》
CAS
CSCD
北大核心
2022年第11期1213-1218,共6页
Chinese Journal of Practical Surgery
基金
辽宁省社发重大专项-胃肠癌精准治疗及临床路径优化研究(No.2019JH1/1030007)。
关键词
结肠肿瘤
腹腔镜
淋巴结清扫
右半结肠癌
D3根治术
colon neoplasm
laparoscopic surgery
lymph node excision
right colon cancer
D3 radical operation
