腹腔镜直肠癌侧方淋巴结清扫术中意外的预防及处理

Prevention and treatment of accidents during laparoscopic lateral lymph node dissection of rectal cancer

直肠癌侧方淋巴结清扫的相关争论近年来取得了部分共识。对于经过术前新辅助治疗仍然存在侧方淋巴结转移的直肠癌病人,侧方淋巴结清扫已经成为一种优先推荐的治疗手段。直肠癌侧方淋巴结清扫的操作区域狭小、血管神经分布密集,手术的安全性一直是外科医生关注的重点问题。通过深入了解直肠侧方重要结构的解剖毗邻、合理应用高清晰的显示系统和操作系统、采用合理的手术入路和操作平面,可显著降低手术风险和减少意外情况的发生、提升手术的安全性,改善直肠癌侧方淋巴结转移病人的远、近期预后。

The debate on lateral lymph node dissection(LLND)of rectal cancer has reached some consensus recently.For patients with rectal cancer who still have lateral lymph node metastasis after preoperative neoadjuvant therapy,LLND has become a priority-recommended treatment.The operation area of LLND of rectal cancer is narrow,and the distribution of blood vessels and nerves is dense.The safety of surgery has always been the focus of surgeons.Through an in-depth understanding of the anatomical proximity of the important structures of the rectum,reasonable use of a high-definition display system and operating system,and reasonable surgical approach and operation plane,the risk of operation and occurrence of accidents will be significantly reduced,the safety of surgery,long-term and short-term prognosis of patients with lateral lymph node metastasis of rectal cancer will be improved.