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根治性右半结肠癌淋巴结清扫范围的探讨

Investigate the radical extent of lymphadenectomy of right colon cancer

摘要:

右半结肠癌根治术的淋巴结清扫范围一直是外科医师关注的热点问题.近年来,随着全结肠系膜切除(CME)理念的建立和不断完善,许多结直肠专科医师认为其应作为结肠癌手术的规范加以推广.但是,我们回顾有关CME研究的中英文文献,发现其在手术适应证的把握、扩大淋巴结清扫可能带来的风险及肿瘤学获益等方面均缺乏令人信服的证据.CME原则是否能达到全直肠系膜切除理念一样的接受程度,取决于更高级别的循证医学证据来明确其手术安全性及肿瘤学优势.

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abstracts:

Considering radical surgeries of right colon cancer,the reasonable extent of lymphadenectomy has always been argued.The concept of complete mesocolic excision (CME) has recently been established and optimized,which follows similar oncological principles as total mesorectal excision (TME) does for rectal cancer and is recommended by more and more surgeons.Studies published so far in the literature have been comprehensively reviewed,they do not,however,provide convincing evidence that demonstrate the standardized operation indications.Moreover,the existence of potential surgical risk and discernible oncological benefit has not been determined.Thus future studies are needed to further investigate the safety and efficacy of CME surgery,as has been demonstrated with TME such that it should become the procedure of choice in surgical practice.

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