Distribution of lymph node metastasis and level of inferior mesenteric artery ligation in colorectal cancer
Distribution of lymph node metastasis and level of inferior mesenteric artery ligation in colorectal cancer
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DOI：
10.1097/00004836-199804000-00006
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发表时间：
1998-04-01
影响因子：
2.9
通讯作者：
Kitano, S
中科院分区：
文献类型：
--
作者：
Adachi, Y;Inomata, M;Kitano, S
为探讨肠系膜下动脉（IMA）淋巴结转移沿着的分布情况，阐明IMA高位结扎的重要性，我们分析了172例乙状结肠癌和直肠癌的手术结果。组织学上，108例（63%）患者无淋巴结转移，64例（37%）患者存在淋巴结转移。分布于直肠壁（35.5%）和乙状结肠（10.5%），沿着IMA（7.7%）和乙状结肠动脉（6.3%），IMA根部（0.7%，1/135）。淋巴结转移（P < 0.01）、浆膜浸润（P <0.05）和肿瘤组织学类型（P <0.05）是预测淋巴结转移的指标。这些结果表明，IMA根部淋巴结转移是罕见的，完全切除结肠周围和中间淋巴结（D2清扫）而不高位结扎IMA是可行的乙状结肠和直肠癌。
To investigate the distribution of lymph node metastasis along the inferior mesenteric artery (IMA) and clarify whether high ligation of the IMA is important or not, we examined the surgical results of 172 patients with cancer of the sigmoid colon and rectum. Histologically, lymph node metastasis was absent in 108 (63%) patients and present in 64 (37%) patients. The distribution was adjacent to the wall of the rectum (35.5%) and sigmoid colon (10.5%), along the IMA (7.7%) and sigmoid colic artery (6.3%), and at the root of the IMA (0.7%, 1 of 135 patients). The presence of lymph node metastasis was predicted by the operative findings of lymph node metastasis (p < 0.01) and serosal invasion (p < 0.05) and by the histologic type of tumor (p < 0.05). These results indicate that lymph node metastasis at the root of the IMA is rare, and complete removal of the pericolic and intermediate nodes (D2 dissection) without high ligation of the IMA is feasible for cancer of the sigmoid colon and rectum.