98肠系膜下动脉低位结扎及根部淋巴结廓清对直肠癌根治术的临床意义

目的探讨肠系膜下动脉（IMA）低位结扎及根部淋巴结廓清对直肠癌根治术的意义。方法对2000～2008年进行的73例肠系膜下动脉低位结扎及根部淋巴结廓清术，和对60例肠系膜下动脉高位结扎及根部淋巴结清除术，进行回顾性总结。结果肠系膜下动脉根部淋巴结转移率为15．1％。肿瘤位于腹膜返折以上者肠系膜下动脉根部淋巴结转移率（22．9％），高于腹膜返折以下者（9．7％）。两者有显著差异（P〈0．05）。随访65例，复发率为4．85％。结论对肿瘤浸润深度达到pT3和pT4的病例；肿瘤位于腹膜返折上者，肠系膜下动脉低位结扎及根部淋巴结廓清，可以有效降低直肠癌术后复发率。

Clinical significance of high ligation of inferior mesenteric artery and lymphadenectomy In rection of rectal cancer

Objective To study the significance of lower ligation of inferior mesenteric artery and lymphadenectomy in rection of rectal cancer.Methods Seventy-three cases of lower ligation of inferior mesenteric artery and lymphadenectomy in of rectal cancer admitted in 2000～2007 were analyzed retrospectively.Results The metastatic rate of the lymph nodes at the root of the inferior mesenteric artery was 15.1%.the lymph nodes at the root of the infedor mesenteric artery occurred more frequently with tumor located upon the poritoneral reflection.Conclusion The patients with pT3 and pT4 stage cancers and with tumor located upon the peritoneral reflection.lower ligation of IMA and an en bloc dissection of surrounding the abdominal aorta should be preformed.This technique would increase the five-year survival rate.