腹腔镜直肠癌根治术中肠系膜下静脉结扎部位的争议

Controversial ligation site of the inferior mesenteric vein in laparoscopic radical resection of rectal cancer

肠系膜下静脉(IMV)结扎离断是直肠癌根治术中关键步骤,国内外对此存在争议。IMV解剖位置关系复杂,术中需要仔细辨识离断。IMV根部存在淋巴结分布,高位结扎IMV是否能够改善直肠癌病人预后,目前仍缺乏循证医学证据。有待开展随机对照研究探讨IMV不同部位结扎方式对直肠癌病人近远期疗效的影响,为IMV的结扎方式选择提供理论支持。

Ligation of the inferior mesenteric vein(IMV)is a critical step in radical resection of rectal cancer,which is controversial both in China and abroad.The anatomical position of IMV is complicated,and the dissection needs to be carefully identified during the operation.There is lymph node distribution at the root of IMV.There is still no evidence-based medical evidence on whether high-level ligation of IMV can improve the prognosis of rectal cancer patients.Randomized controlled studies on the effect of ligation of different parts of IMV on the short-term and long-term outcomes of rectal cancer patients need to be carried out to provide theoretical support for the appropriate ligation of IMV.