侧侧淋巴结解剖的基本解剖学
Yuichiro Yokoyama1, Hiroaki Nozawa1, Kazuhito Sasaki1
1Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Annals of coloproctology
|December 8, 2023
概括
侧侧淋巴结解剖 (LLND) 对于晚期直肠癌至关重要,因为在化疗放射治疗 (CRT) 之前淋巴结被扩大. 了解盆腔解剖学对于安全有效的LLND至关重要,尽管存在挑战.
科学领域:
- 手术瘤学手术瘤学
- 人体解剖学 解剖学 解剖学
- 胃肠病学 胃肠病学
背景情况:
- 标准的直肠癌治疗包括手术前化学辐射疗法 (CRT) 和全腹腔切除术 (TME),但可能不足以治疗侧淋巴结的复发.
- 在CRT之前,扩大的侧淋巴结需要侧淋巴结剖析 (LLND) 来改善复发控制.
研究的目的:
- 为了澄清执行侧侧淋巴结解剖 (LLND) 所需的基本盆腔解剖.
- 为安全和准确的LLND提供全面的解剖学理解,特别是在直肠癌手术的背景下.
主要方法:
- 文献综述,重点关注与直肠手术相关的盆腔解剖学和LLND.
- 整合解剖学知识与手术经验以及从3D模型和手术视图的洞察力.
主要成果:
- 虽然LLND是有效的,但与单独的TME相比,它带来了挑战,包括更长的手术时间,增加的出血和更高的并发症率.
- 安全和功能性的LLND是可以实现的,腹腔镜和机器人方法被广泛采用.
- 准确识别解剖学标志对于防止LLND期间错误识别血管和神经至关重要.
结论:
- 对解剖学标志的彻底理解对于安全和准确的横向淋巴结解剖 (LLND) 执行至关重要.
- 尽管取得了进展,LLND仍然是一个复杂的程序,需要专门的解剖学知识,以获得直肠癌治疗的最佳结果.
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