【摘要】 结肠肝曲癌在结肠癌中虽然所占比例较小,由于其解剖位置及病理特征的关系,却有着较高的复发率,多见幽门下淋巴结转移。在行结肠癌D3根治术时是否行幽门下淋巴结清扫以及其适应证是困扰众多普外科医生的一个重要的临床问题。目前,在右半结肠切除中,D3根治术和完整结肠系膜切除(CME)是被广泛接受的两大理念,也均能取得较为可观的预后。结肠肝曲癌有时需要在行扩大右半结肠癌根治术的同时,行幽门下淋巴结清扫。由于其周围解剖结构比较复杂,手术难度进一步加大。不同术者对结肠肝曲癌可能有着不同的处理方式。目前对结肠肝曲癌幽门下淋巴结清扫的报道相对较少,其具体获益情况仍缺乏针对性评估。更多还原

【Abstract】 Although the proportion of colonic hepatic carcinoma in colon cancer is relatively small,due to its anatomical location and pathological characteristics,it has a higher recurrence rate,and infrapyloric lymph node metastasis is more common.Whether and when to perform infrapyloric lymph node dissection during radical D3 colon cancer surgery is an important clinical problem that perplex many surgeons.The D3 and CME procedures for right colon cancer are currently two widely accepted concepts in right hemicolectomy,and they can also achieve a considerable prognosis. Colonic hepatic flexure cancer sometimes requires infrapyloric lymph node dissection at the same time as radical hemicolectomy.The surrounding anatomy of hepatic flexure cancer is complicated,and the operation is more difficult than D3 radical operation. Different physicians have different treatments for colonic hepatic carcinoma. At present,there are relatively few reports of infrapyloric lymph node dissection of colonic hepatic carcinoma,and the specific benefit situation still lacks targeted evaluation.更多还原