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目的探讨直肠癌术中从根部结扎肠系膜下动脉的临床意义。方法回顾性分析华中科技大学同济医学院附属同济医院2000年1月至2005年12月499例肠系膜下动脉根部结扎的直肠癌临床病理资料。结果肠系膜下动脉根部淋巴结转移率为14·4%。肿瘤分化程度为低分化腺癌、黏液腺癌或印戒细胞癌,肿瘤浸润深度达到pT3和pT4的直肠癌病人,其肠系膜下动脉根部淋巴结转移率较高。结论低分化腺癌、黏液腺癌或印戒细胞癌,浸润深度达到pT3和pT4时,直肠癌肠系膜下动脉根部淋巴结转移率较高,在行直肠癌根治手术时应行肠系膜下动脉根部结扎以提高5年存活率。
Objective To investigate the clinical significance of ligation of inferior mesenteric artery from the root during operation of rectal cancer. Methods The clinical data of 499 rectal cancer patients with inferior mesenteric artery ligation in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2000 to December 2005 were retrospectively analyzed. Results The rate of lymph node metastasis in inferior mesenteric artery was 14.4%. The degree of tumor differentiation of poorly differentiated adenocarcinoma, mucinous adenocarcinoma or signet ring cell carcinoma, tumor depth of invasion of pT3 and pT4 rectal cancer patients, the superior mesenteric artery lymph node metastasis rate was higher. Conclusions In poorly differentiated adenocarcinoma, mucinous adenocarcinoma, or signet-ring cell carcinoma, when the infiltration depth reaches pT3 and pT4, the rate of lymph node metastasis in the rectal cancer is high. In the radical operation of rectal cancer, the root of the inferior mesenteric artery should be ligated Increase 5-year survival rate.