直肠癌根治术中保留左结肠动脉的应用进展
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摘要
目前直肠癌的治疗以手术为主,全直肠系膜切除(total mesorectal excision, TME)原则已成为中下段直肠癌手术治疗的标准术式,但对于肠系膜下动脉(Inferior Mesenteric Artery, IMA)的处理方式仍存在争议。IMA的处理方式主要分为保留左结肠动脉的低位结扎和不保留左结肠动脉的高位结扎。本文结合国内外相关文献对直肠癌根治术中保留左结肠动脉的应用进展进行综述。
At present, surgery is the main treatment of rectal cancer. The principle of total mesorectal resection(TME) has become the standard operation for middle and lower rectal cancer, but there is no consensus on the management of inferior mesenteric artery(IMA) which is mainly divided into low ligation with left colic artery and high ligation without left colic artery. In this paper, the application of preserving left colon artery during radical resection of rectal cancer was reviewed in combination with relevant literatures at home and abroad.
At present, surgery is the main treatment of rectal cancer. The principle of total mesorectal resection(TME) has become the standard operation for middle and lower rectal cancer, but there is no consensus on the management of inferior mesenteric artery(IMA) which is mainly divided into low ligation with left colic artery and high ligation without left colic artery. In this paper, the application of preserving left colon artery during radical resection of rectal cancer was reviewed in combination with relevant literatures at home and abroad.
引文
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[3]Murono K, Kawai K, Kazama S, et al. Anatomy of the inferior mesenteric artery evaluated using 3-dimensional CT angiography[J]. Dis Colon Rectum, 2015,58(2):214-219.DOI:10.1097/DCR.0000000000000285.
[4]Zhou J, Zhang S, Huang J, et al.[Accurate low ligation of inferior mesenteric artery and root lymph node dissection according to different vascular typing in laparoscopic radical resection of rectal cancer][J]. Zhonghua Wei Chang Wai Ke Za Zhi, 2018,21(1):46-52.
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[6]黄俊,周家铭,万英杰,等.肠系膜下动脉血管分型及Riolan动脉弓缺如对腹腔镜直肠癌根治术后吻合口瘘发生率的影响[J].中华胃肠外科杂志, 2016,(10):1113-1118.
[7]胡祥.直肠淋巴引流系统的局部解剖和分类[J].中国实用外科杂志, 2018,(10):1128-1132.
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[10]Malassagne B, Valleur P, Serra J, et al. Relationship of apical lymph node involvement to survival in resected colon carcinoma[J]. Dis Colon Rectum, 1993,36(7):645-653.
[11]Hida J, Okuno K. High ligation of the inferior mesenteric artery in rectal cancer surgery[J]. Surg Today, 2013,43(1):8-19.DOI:10.1007/s00595-012-0359-6.
[12]陈仕才,宋新明,陈志辉,等.肠系膜下动脉结扎方式对乙状结肠癌和直肠癌患者预后影响的Meta分析[J].中华胃肠外科杂志,2010,(9):674-677. DOI:10.3760/cma.j.issn.1671-0274.2010.09.013.
[13]Kanemitsu Y, Hirai T, Komori K, et al. Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery[J]. Br J Surg, 2006,93(5):609-615.DOI:10.1002/bjs.5327.
[14]Singh D, Luo J, Liu XT, et al. The long-term survival benefits of high and low ligation of inferior mesenteric artery in colorectal cancer surgery:A review and meta-analysis[J].Medicine(Baltimore), 2017,96(47):e8520. DOI:10.1097/MD.0000000000008520.
[15]Sekimoto M, Takemasa I, Mizushima T, et al. Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery[J]. Surg Endosc, 2011,25(3):861-866. DOI:10.1007/s00464-010-1284-7.
[16]Goh N, Fong SS, How KY, et al. Apical lymph node dissection of the inferior mesenteric artery[J]. Colorectal Dis, 2016,18(6):O206-209. DOI:10.1111/codi.13299.
[17]Corder AP, Karanjia ND, Williams JD, et al. Flush aortic tie versus selective preservation of the ascending left colic artery in low anterior resection for rectal carcinoma[J]. Br J Surg,1992,79(7):680-682.
[18]Yang Y, Wang G, He J, et al. High tie versus low tie of the inferior mesenteric artery in colorectal cancer:A meta-analysis[J]. Int J Surg, 2018,52:20-24. DOI:10.1016/j.ijsu.2017.12.030.
[19]Bruch HP, Schwandner O, Schiedeck TH, et al. Actual standards and controversies on operative technique and lymphnode dissection in colorectal cancer[J]. Langenbecks Arch Surg, 1999,384(2):167-175.
[20]Ruteg rd M, Hemmingsson O, Matthiessen P, et al. High tie in anterior resection for rectal cancer confers no increased risk of anastomotic leakage[J]. Br J Surg, 2012,99(1):127-132. DOI:10 .1002/bjs.7712.
[21]Komen N, Slieker J, de Kort P, et al. High tie versus low tie in rectal surgery:comparison of anastomotic perfusion[J]. Int J Colorectal Dis, 2011,26(8):1075-1078. DOI:10.1007/s00384-011-1188-6.
[22]Tsujinaka S, Kawamura YJ, Tan KY, et al. Proximal bowel necrosis after high ligation of the inferior mesenteric artery in colorectal surgery[J]. Scand J Surg, 2012,101(1):21-25. DOI:10 .1177/145749691210100105.
[23]Bonnet S, Berger A, Hentati N, et al. High tie versus low tie vascular ligation of the inferior mesenteric artery in colorectal cancer surgery:impact on the gain in colon length and implications on the feasibility of anastomoses[J]. Dis Colon Rectum, 2012,55(5):515-521. DOI:10.1097/DCR.0 b013e318246 f1a2.
[24]Buunen M, Lange MM, Ditzel M, et al. Level of arterial ligation in total mesorectal excision(TME):an anatomical study[J].Int J Colorectal Dis, 2009,24(11):1317-1320. DOI:10.1007/s00384-009-0761-8.
[25]Reddy SH, Gupta V, Yadav TD, et al. Lengthening of left colon after rectal resection:What all is adequate? A prospective cohort study[J]. Int J Surg, 2016,31:27-32. DOI:10.1016/j.ijsu.2016.05.042.
[26]王庆广,张彩坤,张豪英,等.肠系膜下动脉结扎水平对直肠癌术后排粪功能的影响[J].中华胃肠外科杂志,2015,(11):1132-1135. DOI:10.3760/cma.j.issn.1671-0274.2015.11.016.
[27]伍颖君,李民.保留左结肠动脉应用于腹腔镜低位直肠前切除术的临床研究[J].中华胃肠外科杂志, 2017,(11):1313-1315.
[28]Beveridge TS, Allman BL, Johnson M, et al. Retroperitoneal Lymph Node Dissection:Anatomical and Technical Considerations from a Cadaveric Study[J]. J Urol, 2016,196(6):1764-1771.
[29]屈景辉,贺佳蓓,张琦,等.保留左结肠动脉在腹腔镜直肠癌前切除术中的临床应用[J].实用医学杂志, 2018,(17):2900-2903.
[2]Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery--the clue to pelvic recurrence?[J]. Br J Surg,1982,69(10):613-616.
[3]Murono K, Kawai K, Kazama S, et al. Anatomy of the inferior mesenteric artery evaluated using 3-dimensional CT angiography[J]. Dis Colon Rectum, 2015,58(2):214-219.DOI:10.1097/DCR.0000000000000285.
[4]Zhou J, Zhang S, Huang J, et al.[Accurate low ligation of inferior mesenteric artery and root lymph node dissection according to different vascular typing in laparoscopic radical resection of rectal cancer][J]. Zhonghua Wei Chang Wai Ke Za Zhi, 2018,21(1):46-52.
[5]程邦昌,昌盛,黄杰,等.结肠代食管术中结肠血管结构的研究[J].中华医学杂志,2006,(21):1453-1456. Natl Med J China,2006,(21):1453-1456.
[6]黄俊,周家铭,万英杰,等.肠系膜下动脉血管分型及Riolan动脉弓缺如对腹腔镜直肠癌根治术后吻合口瘘发生率的影响[J].中华胃肠外科杂志, 2016,(10):1113-1118.
[7]胡祥.直肠淋巴引流系统的局部解剖和分类[J].中国实用外科杂志, 2018,(10):1128-1132.
[8]Chen H, Wang Y, Liu H, et al. Factors influencing apical node metastasis in colorectal cancer patients treated with laparoscopic radical resection with D3 lymphadenectomy:results from two centers in China[J]. Surg Today, 2015,45(5):569-575. DOI:10 .1007/s00595-014-1013-2.
[9]Titu LV, Tweedle E, Rooney PS. High tie of the inferior mesenteric artery in curative surgery for left colonic and rectal cancers:a systematic review[J]. Dig Surg, 2008,25(2):148-157 . DOI:10.1159/000128172.
[10]Malassagne B, Valleur P, Serra J, et al. Relationship of apical lymph node involvement to survival in resected colon carcinoma[J]. Dis Colon Rectum, 1993,36(7):645-653.
[11]Hida J, Okuno K. High ligation of the inferior mesenteric artery in rectal cancer surgery[J]. Surg Today, 2013,43(1):8-19.DOI:10.1007/s00595-012-0359-6.
[12]陈仕才,宋新明,陈志辉,等.肠系膜下动脉结扎方式对乙状结肠癌和直肠癌患者预后影响的Meta分析[J].中华胃肠外科杂志,2010,(9):674-677. DOI:10.3760/cma.j.issn.1671-0274.2010.09.013.
[13]Kanemitsu Y, Hirai T, Komori K, et al. Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery[J]. Br J Surg, 2006,93(5):609-615.DOI:10.1002/bjs.5327.
[14]Singh D, Luo J, Liu XT, et al. The long-term survival benefits of high and low ligation of inferior mesenteric artery in colorectal cancer surgery:A review and meta-analysis[J].Medicine(Baltimore), 2017,96(47):e8520. DOI:10.1097/MD.0000000000008520.
[15]Sekimoto M, Takemasa I, Mizushima T, et al. Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery[J]. Surg Endosc, 2011,25(3):861-866. DOI:10.1007/s00464-010-1284-7.
[16]Goh N, Fong SS, How KY, et al. Apical lymph node dissection of the inferior mesenteric artery[J]. Colorectal Dis, 2016,18(6):O206-209. DOI:10.1111/codi.13299.
[17]Corder AP, Karanjia ND, Williams JD, et al. Flush aortic tie versus selective preservation of the ascending left colic artery in low anterior resection for rectal carcinoma[J]. Br J Surg,1992,79(7):680-682.
[18]Yang Y, Wang G, He J, et al. High tie versus low tie of the inferior mesenteric artery in colorectal cancer:A meta-analysis[J]. Int J Surg, 2018,52:20-24. DOI:10.1016/j.ijsu.2017.12.030.
[19]Bruch HP, Schwandner O, Schiedeck TH, et al. Actual standards and controversies on operative technique and lymphnode dissection in colorectal cancer[J]. Langenbecks Arch Surg, 1999,384(2):167-175.
[20]Ruteg rd M, Hemmingsson O, Matthiessen P, et al. High tie in anterior resection for rectal cancer confers no increased risk of anastomotic leakage[J]. Br J Surg, 2012,99(1):127-132. DOI:10 .1002/bjs.7712.
[21]Komen N, Slieker J, de Kort P, et al. High tie versus low tie in rectal surgery:comparison of anastomotic perfusion[J]. Int J Colorectal Dis, 2011,26(8):1075-1078. DOI:10.1007/s00384-011-1188-6.
[22]Tsujinaka S, Kawamura YJ, Tan KY, et al. Proximal bowel necrosis after high ligation of the inferior mesenteric artery in colorectal surgery[J]. Scand J Surg, 2012,101(1):21-25. DOI:10 .1177/145749691210100105.
[23]Bonnet S, Berger A, Hentati N, et al. High tie versus low tie vascular ligation of the inferior mesenteric artery in colorectal cancer surgery:impact on the gain in colon length and implications on the feasibility of anastomoses[J]. Dis Colon Rectum, 2012,55(5):515-521. DOI:10.1097/DCR.0 b013e318246 f1a2.
[24]Buunen M, Lange MM, Ditzel M, et al. Level of arterial ligation in total mesorectal excision(TME):an anatomical study[J].Int J Colorectal Dis, 2009,24(11):1317-1320. DOI:10.1007/s00384-009-0761-8.
[25]Reddy SH, Gupta V, Yadav TD, et al. Lengthening of left colon after rectal resection:What all is adequate? A prospective cohort study[J]. Int J Surg, 2016,31:27-32. DOI:10.1016/j.ijsu.2016.05.042.
[26]王庆广,张彩坤,张豪英,等.肠系膜下动脉结扎水平对直肠癌术后排粪功能的影响[J].中华胃肠外科杂志,2015,(11):1132-1135. DOI:10.3760/cma.j.issn.1671-0274.2015.11.016.
[27]伍颖君,李民.保留左结肠动脉应用于腹腔镜低位直肠前切除术的临床研究[J].中华胃肠外科杂志, 2017,(11):1313-1315.
[28]Beveridge TS, Allman BL, Johnson M, et al. Retroperitoneal Lymph Node Dissection:Anatomical and Technical Considerations from a Cadaveric Study[J]. J Urol, 2016,196(6):1764-1771.
[29]屈景辉,贺佳蓓,张琦,等.保留左结肠动脉在腹腔镜直肠癌前切除术中的临床应用[J].实用医学杂志, 2018,(17):2900-2903.