保留直肠上动脉的肠系膜下血管旁淋巴结清扫技巧

Surgical Technique on Lymph Node Dissection of Adjacent Inferior Mesenteric Blood Vessels with Superior Rectal Artery Preserving

目的探讨保留直肠上动脉淋巴清扫的方法及手术技巧。方法 2010年1月～2012年1月对32例结肠癌患者,采用直肠上动脉全程裸化的方法清扫肠系膜下血管旁淋巴结,并与传统保留直肠上动脉方法所清扫的淋巴结数目进行比较。结果全程裸化方法所清扫的淋巴结数目为612枚,平均(18.96±1.54)枚,明显多于传统方法 450枚,平均(14.06±1.1)枚(P<0.01),而两种方法检获的淋巴结阳性率比较无显著性差异(52 VS 49,P>0.05)。结论直肠上动脉全程裸化是保留直肠上动脉淋巴清扫的安全、有效的方法之一。

Objective To discuss the method and skills of lymph node dissection with preserving superior rectal artery. Methods A total of 32 colonic cancer cases admitted from January 2010 to January 2012 were carried out left hemicolectomy. The technique of whole superior rectal artery skeletonization was per- formed in lymphadenectomy of adjacent inferior mesentery blood vessels in all cases. The lymph node numbers were compared between the skeletonization method and traditional superior rectal artery preserving method. Results The lymph node numbers was 612 with an average of 18.96± 1.54 via skeletonization method, and was 450 with an average of 14.06 ± 1.1 via tradition method, and there was remarkable difference between two methods（P 〈 0.01 ）. But no statistic difference in lymph node positive rate between two methods （52 VS 49, P 〉 0.05 ）. Conclusion The technique of whole superior rectal artery skeletonization is a safe and effective lymphadeneetomy method with preserving superior rectal artery.