中央血管结扎和全结肠系膜切除术与D3淋巴结切除术:手术技术的标准化。

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Sung Uk Bae
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引用次数: 0

摘要

外科手术的进步已经改变了结直肠癌的治疗方式,肠系膜完全切除(CME)成为保证肿瘤安全性和有效性的关键方法。Yadav的文章强调了CME在获得最佳切除边缘,彻底清扫淋巴结和提高长期生存率方面的意义。D3淋巴结切除术的辅助功能,强调淋巴引流沿供应血管的清除,也被讨论。CME联合中央血管结扎,基于直肠癌全肠系膜切除的原则,需要整体切除肿瘤并沿胚胎平面精确剥离,从而减少复发率,提高生存率。微创技术(如腹腔镜CME)的可行性和安全性已得到证实;然而,由于复杂的血管解剖结构,技术上的困难仍然存在。机器人辅助手术具有潜在的优势,包括精确的淋巴清扫和体内吻合。然而,由于成本高且持续时间长,证明其优于腹腔镜技术的证据很少。本研究促进了CME作为现代结直肠癌手术基本要素的全球标准化。CME是当代肿瘤学实践的缩影,需要广泛采用以取得结肠癌管理的优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Central vascular ligation and complete mesocolon excision vs D3 lymphadenectomy: Standardization of surgical technique.

Surgical advancements have transformed colorectal cancer treatment, with complete mesocolic excision (CME) becoming a crucial method to guarantee oncological safety and effectiveness. The article by Yadav emphasized the significance of CME in attaining optimal resection margins, thorough lymph node dissection, and enhanced long-term survival rates. The adjunctive function of D3 lymphadenectomy, emphasizing the clearance of lymphatic drainage along the supplying vessels, was also addressed. CME with central vascular ligation, based on the principles of total mesorectal excision for rectal cancer, entails en bloc tumor resection and precise dissection along the embryological planes, thus diminishing recurrence and improving survival rates. The viability and safety of minimally invasive techniques, such as laparoscopic CME, have been confirmed; however, technical difficulties remain owing to the intricate vascular anatomy. Robotic-assisted surgery presents potential benefits, including accurate lymphatic dissection and intracorporeal anastomosis. However, evidence demonstrating its superiority over laparoscopic techniques is scarce owing to high costs and prolonged duration. This study promotes the global standardization of CME as an essential element of modern colorectal cancer surgery. CME epitomizes contemporary oncological practices, requiring widespread adoption to achieve superiority in colon cancer management.

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