【摘要】 目的:为临床扩大根治性直肠切除术提供解剖学资料。方法:对８具成人尸体标本的直肠侧方淋巴结等进行解剖观察。结果:８具标本盆腔解剖结构辩认清楚,明确了直肠侧方各组淋巴结的解剖定位。侧方向淋巴结包括前、后、中、下组,分别沿相关的血管分布。在直肠周围脂肪与盆壁之间存在着直肠后间隙,脏层筋膜所包绕的直肠周围脂肪、血管及淋巴管即为直肠系膜。腹下神经沿输尿管和髂内动脉向侧、尾方走行,并于发自Ｓ２~４神经根的盆内脏神经在盆腔侧壁汇合成盆自主神经。结论:低位直肠癌的转移特点是直肠上方向和侧方向淋巴结转移,扩大根治性直肠切除术有助于降低低位直肠癌术后的局部复发,提高远期疗效。更多还原

【Abstract】 Objective: To provide anatomical data for extended radical rectectomy. Methods: Eight adult cadaveric specimens were studied and anatomized. Results: All the pelvic structures of the 8 cadaveric specimens were clarified, and the anatomical position of all the groups of lateral lymph nodes was well-known. The lateral lymph nodes include anterior, posterior, intermediate and lower groups, which located along related vessels respectively. The retrorectal space lay between the rectum pericapsula fat and pelvis.The rectum pericapsula, vessel and lymph tube were surrounded by viscerale fascia and formed mesorectum. Hypogastric nerve went along ureter and internal iliac artery toward sides and tails, and converged with pelvic splanchnic nerve which origined from S2-4 to form pelvis autonomic nerve. Conclusion: The lymphatic metastasis of low rectal cancer is mainly upward and to lateral, so the extended radical rectectomy can reduce the local recurrence of low rectal cancer and improve survival. The prognosis is better.更多还原