D3淋巴结解剖程度对右侧结肠癌的术后肠功能和营养状况的影响:一项前性随机对照试验
Xinxiu Zhou1, Zhou Shang2, Feng Tian2
1Department of Critical Care Medicine, Shandong Provincial Second People's Hospital, Jinan, Shandong, China.
International journal of surgery (London, England)
|September 10, 2025
概括
在右侧结肠癌手术中,将D3淋巴切除术延伸到上层介质动脉 (SMA) 增加了淋巴结的检索能力,但导致了更多的术后腹和质泄漏. 功能恢复和瘤结局没有显著改善.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 临床试验 临床试验
背景情况:
- D3淋巴切除术的程度会影响右侧结肠癌手术的结果.
- 手术后腹显著影响患者的生活质量.
研究的目的:
- 研究D3淋巴切除术边界对肠道功能和营养状况的影响.
- 为了比较延伸到上半腹静脉 (SMV) 和上半腹动脉 (SMA) 的剖析结果.
主要方法:
- 未来随机对照试验涉及76名右侧结肠癌患者.
- 患者被随机分配到SMV或SMA组淋巴切除术中.
- 主要结局:手术后腹的发生率;次要结局:皮质泄漏,淋巴结产量,恢复和营养状况.
主要成果:
- 在SMA组中,术后腹的发生率 (39.5%与18.4%) 和流泄漏 (21.1%与5.3%) 显著更高.
- 在SMA组中检索更多的淋巴结,但阳性淋巴结数量没有差异.
- 亚组分析显示,女性患者的腹增加,SMA组的I-II期瘤增加. 没有观察到恢复或营养方面的显著差异.
结论:
- 将D3淋巴切除术扩展到SMA增加了淋巴结产量,但与手术后腹和皮质泄漏的更高率有关.
- 这种方法没有明显的短期瘤益处,强调需要平衡手术程度与功能恢复.
- 研究结果支持对结肠癌患者进行个性化外科规划和共享决策.
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