右半结肠癌No.206组淋巴结转移的观察研究

目的:分析右半结肠癌No.206组淋巴结转移的规律,为淋巴结的清扫提供临床参考.方法:回顾性收集2015年1月至2019年12月完成的111例右半结肠癌根治术患者的临床资料.观察指标:人口学特征、手术与术后恢复情况、术后病理学检查、随访及生存情况.结果:111例患者中男59例,女52例,中位年龄60岁.肿瘤部位回盲部9...

Observational study of No.206 lymph nodes metastasis in right colon cancer patients

Objective:To investigate the pattern of No.206 lymph nodes metastasis in right colon cancer patients in order to provide clinical reference of lymph nodes dissection.Methods:Clinical pathological data of 111 right colon cancer patients receiving radical operation from Jan.2015 to Dec.2019 were retrospectively analyzed.Observation indicators included demographic characteristics,intraoperative conditions,postoperative recovery,postoperative pathological examinations,follow-up and survival.Results:Among the 111 patients,there were 59 male and 52 female patients.The median age was 60 years.There were 9 patients with tumor located in the cecum,37 in the ascending colon,62 in the hepatic flexure and 3 in the right side of transverse colon.All patients underwent right-hemicolectomy successfully.79 patients were performed with laparoscopic surgery,8 with open surgery and 24 with Da Vinci robotic surgery.One laparoscopy was converted to laparotomy.Operation time was 110(98,115)min.Operative blood loss was 30(20,50)mL.Time for the first postoperative bowel movement was 4(3,5)d.Postoperative hospital stay was 7(6,8)d.The total complication rate was 9.9%(11/111),with 5 cases of incision fat liquefaction/infection,5 chylous fistula and 1 anastomotic bleeding.There were 17 cases of TNM stage Ⅰ,44 cases of stage Ⅱ,49 cases of stage Ⅲ and 1 case of stage Ⅳ.The median total lymph node count was 27(23,31),median positive lymph node count was 0(0,2).The metastasis rate of lymph node was 44.14%(49/111).With respect to No.206 lymph nodes,the median number of its harvest was 3(1,4),median positive lymph node count was 0(0,0).The metastasis rate of No.206 lymph nodes was 0.9%(1/111).102(91.9%)patients were followed up with a median time of 23 months(range 7 to 65 months).9 patients were lost to follow-up.The 5-year overall survival rate and the 5-year tumor-free survival rate were 86.3% and 73.4%,respectively.Conclusions:Concerning the low metastasis rate of No.206 lymph nodes of right colon cancer,lymph node dissection is recommended in patients with locally advanced colon cancer in hepatic flexure or suspected No.206 lymph nodes metastasis.