直肠癌术中从根部结扎肠系膜下动脉临床意义探讨

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。

Effect of high ligation of inferior mesenteric artery in rectal cancer surgery

Objective To evaluate the clinical effect of high ligation of inferior mesenteric artery in rectal cancer surgery .Methods Four hundreds and ninety-nine patients with rectal cancer underwent high ligation of inferior mesenteric artery in Tongji hospital of Tongji Medical College,Huazhong University of Science and Technology between January 2000 and December 2005 were reviewed retrospectively.Results The metastatic rate of the lymph nodes at the root of the inferior mesenteric artery was 14.4%.The inferior mesenteric artery root nodal metastasis occurred more frequently with low differentiation adenocarcinoma,mucous adenocarcinoma,signet-ring cell cancer and pT3 or pT4 stage rectal cancer.Conclusion In radical surgery of rectal cancer, the high ligation of the inferior mesenteric artery should be performed for the following risk factors:patients with low differentiation adenocarcinoma,mucous adenocarcinoma,signet-ring cell cancer and pT3 or pT4 stage rectal cancer.The high ligation of the inferior mesenteric artery can improve 5-year survival rate.