直肠系膜淋巴结分布特点及其临床意义

Anatomic study and clinical apply of the lymph nodes of the mesorectum

目的 :通过研究尸体及活体术后标本观察直肠系膜淋巴结的数目及分布 ,探讨直肠癌全直肠系膜切除术后患者的复发和转移之间的关系。方法 :3 0例福尔马林固定的尸体和 10 2例活体术后标本解剖 ,自直肠上动脉开始沿其最小的分支至肛门直肠环水平进行解剖并登记。结果 :3 0例尸体标本直肠系膜共发现淋巴结 2 48枚 ,平均 8.3枚 (标准差 4.41) ,淋巴结大小为 1.8～ 10mm。 10 2例行直肠癌全直肠系膜切除术的病例共发现淋巴结 916枚淋巴结 ,平均 8.98枚。所有淋巴结均送病理 ,其中有 77枚( 8.41% )有癌转移。结论 :通过尸体与活体标本淋巴结的解剖 ,大部分淋巴结分布在直肠系膜周围靠近腹膜返折处。淋巴结数目变化范围可指导直肠癌全直肠系膜切除术后标本的病理解剖及指导术后病人的治疗。

Objective: To determine relationship for total mesorectal excision in rectal cancer what recrudescence and diversion post-operation. Methods: 30 formalin-fixed cadaver and 102 cases vivisection pelvises were dissected .The search for lymph nodes was performed in a systematic way, from the division of the superior rectory following the smallest visible branches to the anorectal cancer . Results: A total of 248 lymph nodes were found in 30 mesorectal blocks, with a mean number per specimen of 8.3. Lymph nodes size ranged from 1.8 to 10 mm. In 102 cases vivisection pelvises of a total of 916 lymph nodes were found in mesorectal blocks , with a mean number per specimen of 8.98. Lymph nodes size ranged from 1.8 to 10 mm. Conclusion: Most of these lymph nodes were proximal to the peritoneal reflection. The range found in the number of lymph nodes per case should be considered for use in the formulation of guidelines in anatomicopathologic studies of surgical specimens and vivisertions which were obtained after total mesorectal excision.