第四节 小结
右半结肠癌的治疗需要建立在对系膜解剖结构和淋巴引流规律深刻理解的基础上,各种治疗理念的衍生和发展都不能脱离肿瘤根治的基本原则。目前右半结肠癌手术逐步规范,但在淋巴结清扫边界、手术范围等关键问题仍存在较大争议。因此在保证患者安全和肿瘤根治性的基础上,开展科学的临床研究,补充治疗指南的模糊空白之处,以期为患者带来最佳的治疗效果,仍是现阶段外科学者的重要任务。
(刁德昌、冯晓创)
参考文献
[1]ISHIHARA S,MURONO K,SASAKI K,et al.Impact of Primary Tumor Location on Postoperative Recurrence and Subsequent Prognosis in Nonmetastatic Colon Cancers[J].Annals of Surgery,2018,267(5):917-921.DOI:10.1097/SLA.0000000000002206.
[2]KIM J,LEE H S,LEE H J,et al.Long-Term Outcomes of Endoscopic Versus Surgical Resection of Superficial Submucosal Colorectal Cancer[J].Digestive Diseases and Sciences,2015,60(9):2785-2792.DOI:10.1007/s10620-015-3530-2.
[3]HAN J,HUR H,MIN B S,et al.Predictive Factors for Lymph Node Metastasis in Submucosal Invasive Colorectal Carcinoma: A New Proposal of Depth of Invasion for Radical Surgery[J].World Journal of Surgery,2018,42(8):2635-2641.DOI:10.1007/s00268-018-4482-4.
[4]KLOS D,RISKO J,LOVECEK M,et al.Trends in peritoneal surface malignancies: evidence from a Czech nationwide population-based study[J].World J Surg Oncol,2019,17(1):182.DOI:10.1186/s12957-019-1731-4.
[5]MO S,ZHOU Z,YING Z,et al.Epidemiology of and prognostic factors for appendiceal carcinomas: a retrospective,population-based study[J].International Journal of Colorectal Disease,2019,34(11):1915-1924.DOI:10.1007/s00384-019-03387-y.
[6]PARK I J,CHOI G,KANG B M,et al.Lymph Node Metastasis Patterns in Right-Sided Colon Cancers: Is Segmental Resection of These Tumors Oncologically Safe?[J].Annals of Surgical Oncology,2009,16(6):1501-1506.DOI:10.1245/s10434-009-0368-x.
[7]SOBIN LGM W C.International Union Against Cancer TNM Classification of Malignant Tumours,7th edn [J].Wiley-Blackwell,Hoboken,2009.
[8]NESGAARD J M,STIMEC B V,SOULIE P,et al.Defining minimal clearances for adequate lymphatic resection relevant to right colectomy for cancer: a post-mortem study[J].Surgical Endoscopy,2018,32(9):3806-3812.DOI:10.1007/s00464-018-6106-3.
[9]高桥孝.大肠癌根治手术[M].韩方海,译.第1 版.北京:人民卫生出版社,2003:96-98.
[10]MERRIE A E H,PHILLIPS L V,YUN K,et al.Skip metastases in colon cancer: Assessment by lymph node mapping using molecular detection[J].Surgery,2001,129(6):684-691.DOI:10.1067/msy.2001.113887.
[11]TAN K Y,KAWAMURA Y J,MIZOKAMI K,et al.Distribution of the first metastatic lymph node in colon cancer and its clinical significance[J].Colorectal Disease,2010,12(1):44-47.DOI:10.1111/j.1463-1318.2009.01924.x.(https://www.daowen.com)
[12]BENZ S,TAM Y,TANNAPFEL A,et al.The uncinate process first approach: a novel technique for laparoscopic right hemicolectomy with complete mesocolic excision[J].Surgical Endoscopy,2016,30(5):1930-1937.DOI:10.1007/s00464-015-4417-1.
[13]KANEMITSU Y,KOMORI K,KIMURA K,et al.D3 Lymph Node Dissection in Right Hemicolectomy with a No-touch Isolation Technique in Patients With Colon Cancer[J].Diseases of the Colon & Rectum,2013,56(7):815-824.DOI:10.1097/DCR.0b013e3182919093.
[14]周乐其,冯波,苏浩.腹腔镜右半结肠癌D3 根治术淋巴结清扫内侧界队列研究(附 134 例报告)[J].中国实用外科杂志,2019,39(7):712-715.
[15]孙跃明,封益飞,张冬生,等.以肠系膜上动脉为导向的右半结肠全结肠系膜切除术治疗右半结肠癌的应用价值[J].中华消化外科杂志,2019,18(8):753-760.
[16]苏向前,张成海.腹腔镜右半结肠癌CME根治术与策略[J].中华普外科手术学杂志(电子版),2017,11(2):95-98.
[17]刁德昌,卢新泉,何耀彬,等.动脉优先入路法腹腔镜右半结肠癌根治术的可行性及应用价值[J].中华胃肠外科杂志,2017,2(09):42-44.
[18]刁德昌,万进,易小江,等.腹腔镜下保留植物神经右半结肠癌D3 根治术的可行性及应用价值[J].中华胃肠外科杂志,2018(8):908-912.
[19]YI X,LU X,LI H,et al.Feasibility and efficacy of laparoscopic radical right hemicolectomy with complete mesocolic excision using an‘artery-first’ approach[J].Gastroenterology Report,2019,7(3):199-204.DOI:10.1093/gastro/goy047.
[20]YI X,LI H,LU X,et al.“Caudal-to-cranial” plus “artery first” technique with beyond D3 lymph node dissection on the right midline of the superior mesenteric artery for the treatment of right colon cancer: is it more in line with the principle of oncology?[J].Surgical Endoscopy,2019.DOI:10.1007/s00464-019-07171-5.
[21]HASHIGUCHI Y,MURO K,SAITO Y,et al.Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer[J].International Journal of Clinical Oncology,2020,25(1):1-42.DOI:10.1007/s10147-015-0801-z.
[22]Japanese Society for Cancer of the Colon and Rectum.Japanese Classification of Colorectal,Appendiceal,and Anal Carcinoma: the 3d English Edition [Secondary Publication][J].Journal of the Anus,Rectum and Colon,2019,3(4):175-195.DOI:10.1111/ases.12311.
[23]UEMATSU D,AKIYAMA G,SUGIHARA T,et al.Laparoscopic radical lymph node dissection for advanced colon cancer close to the hepatic flexure[J].Asian Journal of Endoscopic Surgery,2017,10(1):23-27.
[24]孙跃明,封益飞,唐俊伟,等.腹腔镜右半结肠癌根治术的争议和手术技巧[J].中华消化外科杂志,2019,18(5):426-429.