CAJ | 학술논문

直肠癌手术中清扫位于肠系膜下动脉根部的第3站淋巴结,可以降低直肠癌的复发率和转移率.如何既能保证规范的第3站淋巴结清扫又能充分保障左侧剩余肠段的血供值得临床医师进一步探讨.2012年1月至2013年3月吉林大学第一医院对133例直肠癌患者施行了腹腔镜保留左半结肠血管的第3站淋巴结清扫术.133例患者均顺利施行该手术,无一例中转开腹,无术中并发症发生,术后总体并发症发生率为6.77％(9/133).118例患者随访2～16个月,中位随访时间为7个月,2例患者出现肝转移,6例肿瘤标志物水平升高,但腹腔内未见明确肿瘤复发及转移征象,其余患者无异常表现.腹腔镜保留左半结肠血管的直肠癌第3站淋巴结清扫术安全可行.
직장암수술중청소위우장계막하동맥근부적제3참림파결,가이강저직장암적복발솔화전이솔.여하기능보증규범적제3참림파결청소우능충분보장좌측잉여장단적혈공치득림상의사진일보탐토.2012년1월지2013년3월길림대학제일의원대133례직장암환자시행료복강경보류좌반결장혈관적제3참림파결청소술.133례환자균순리시행해수술,무일례중전개복,무술중병발증발생,술후총체병발증발생솔위6.77％(9/133).118례환자수방2～16개월,중위수방시간위7개월,2례환자출현간전이,6례종류표지물수평승고,단복강내미견명학종류복발급전이정상,기여환자무이상표현.복강경보류좌반결장혈관적직장암제3참림파결청소술안전가행.
D3 lymph node dissection could reduce the recurrent and metastatic rates of rectal cancer.How to completely dissect No.3 lymph node and protect the left colic vessels deserve further investigation.From January 2012 to March 2013,133 patients with rectal cancer received laparoscopic D3 lymph node dissection with preservation of left colic vessels in the First Affiliated Hospital of Jilin University.The recovery and postoperative complications were observed.The operation was successfully carried out with no conversion to open surgery and no intraoperative complications.The incidence of postoperative complications was 6.77％ (9/133).A total of 118 patients were followed up for 2-16 months,and the median time of follow-up was 7 months.Two patients were complicated with liver metastasis,6 with elevation of tumor markers,while no signs of tumor recurrence or metastasis were detected.The condition of other patients was normal.Laparoscopic D3 lymph node dissection with preservation of left colic vessels for the treatment of rectal cancer is feasible and safe.