Distribution of lymph node metastasis in T1 sigmoid colon carcinoma: Should we ligate the inferior mesenteric artery?
Distribution of lymph node metastasis in T1 sigmoid colon carcinoma: Should we ligate the inferior mesenteric artery?
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DOI：
10.1080/00365520510015746
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发表时间：
2005-07-01
影响因子：
1.9
通讯作者：
Konishi, F
中科院分区：
文献类型：
--
作者：
Kawamura, YJ;Sakuragi, M;Konishi, F
Objective.在标准的肿瘤学乙状结肠切除术中，肠系膜下动脉在其起始处或在左结肠动脉水平处结扎。然而，在早期癌症患者中，转移性淋巴结的分布可能是有限的。本研究的目的是明确T1乙状结肠癌淋巴结转移的发生率和分布，并确定适当的淋巴结清扫范围。材料和方法。该研究包括121例连续T1乙状结肠癌患者。分析与淋巴结转移相关的临床病理因素及转移淋巴结的分布情况。结果121例患者中，12例（10%）有淋巴结受累。浸润深度、淋巴管和血管浸润与淋巴结转移显著相关。在这12例患者中，11例（92%）淋巴结转移局限于结肠周围淋巴结。1例患者累及乙状窦动脉沿着的淋巴结。沿上级直肠动脉或肠系膜下动脉根部无沿着受累结节。结论. T1期乙状结肠癌的淋巴结清扫应局限于乙状结肠动脉根部，保留肠系膜下动脉。
Objective. In standard oncological sigmoid colectomy, the inferior mesenteric artery is ligated either at its origin or at the level of the left colic artery. However, in patients with early-stage carcinoma, the distribution of metastatic nodes may be limited. The aim of this study was to clarify the prevalence and distribution of lymph node metastasis in T1 sigmoid colon carcinoma and to determine the adequate range of lymph node dissection. Material and methods. The study included 121 consecutive patients treated for T1 sigmoid colon carcinoma. Clinicopathologic factors associated with nodal metastasis and the distribution of metastatic nodes were analyzed. Results. Of 121 patients, 12 (10%) had nodal involvement. The depth of invasion and the presence of lymphatic and vascular invasion were significantly associated with nodal metastasis. Of these 12 patients, 11 (92%) had lymph node metastasis confined to pericolic nodes. Nodes along the sigmoidal artery were involved in one patient. There was no involved node along the superior rectal artery or at the root of the inferior mesenteric artery. Conclusions. Lymph node dissection for T1 sigmoid colon carcinoma should be limited to the root of the sigmoidal artery, and the inferior mesenteric artery should be preserved.