结直肠癌腹主动脉旁淋巴结清扫研究进展

LectureAdvancements in research on para-aortic lymph node dissection in colorectal cancer

结直肠癌腹主动脉旁淋巴结转移相对罕见。文献显示, 根治性腹主动脉旁淋巴结清扫可使部分患者获得类似Ⅲ期结直肠癌的预后。关于结直肠癌腹主动脉旁淋巴结转移的手术指征、清扫区域和处理原则, 仍有很多问题尚存争议, 制约了该技术的推广和疗效评价。随着腹腔镜结直肠手术技术的提升, 使得腹主动脉旁淋巴结清扫这项曾因操作复杂、高风险而令很多外科医生望而却步的术式变得安全可行。但该领域尚存在诸多问题, 为了证实这项操作的生存获益, 亟待开展多中心临床研究, 以获得更多的高级别循证医学证据。

Para-aortic lymph node metastasis from colorectal cancer is relatively rare.Recent studies have shown that curative para-aortic lymph node dissection can lead to similar prognoses as stage III colorectal cancer for selected patients.However,there are still many unresolved debates regarding the appropriate surgical indications,extent of lymph node dissection,and treatment principles for colorectal cancer patients with para-aortic lymph node metastasis.With the continuous improvement of laparoscopic colorectal surgery techniques,the previously complex and high-risk procedure of para-aortic lymph node dissection has now become a safe and feasible approach.However,there are still several challenges that need to be addressed in this field.It is imperative to conduct multicenter clinical studies to demonstrate the survival benefits of this surgical procedure into greater survival benefits.This will help generate more robust evidence in the field of evidence-based medicine.