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首页> 外文期刊>Surgical Endoscopy >Feasibility of laparoscopic D3 lymphadenectomy for male rectosigmoid cancer with clinically positive lymph nodes.
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Feasibility of laparoscopic D3 lymphadenectomy for male rectosigmoid cancer with clinically positive lymph nodes.

机译：腹腔镜D3淋巴结清扫术治疗男性直肠乙状结肠癌淋巴结阳性的可行性。

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BACKGROUND: Laparoscopic D3 lymphadenectomy is a challenging surgical procedure and has not been reported before. The present study aimed to test the technical feasibility of this procedure. METHODS: Fifty-four consecutive male patients with clinically staged III rectosigmoid cancer were recruited to undergo laparoscopic D3 lymph node dissection. The extent of the D3 lymphadenectomy of rectosigmoid cancer included skeletonization of bilateral common iliac arteries and veins and abdominal aorta upwards to the level of the duodenal third portion and left renal vein, in addition to the mesenteric dissection in the standard anterior resection. The patients were prospectively followed for surgical feasibility, efficiency, and outcomes. RESULTS: Laparoscopic D3 lymphadenectomy for rectosigmoid cancer was performed with acceptable operation time (303.4 +/- 35.8 min, mean +/- standard deviation) and moderate blood loss (344.8 +/- 50.6 ml) through small wounds. There was no mortality within 30 days after operation and the complication rate was acceptable (20.4%). The patients has quick functional recovery, as evaluated by the restoration of flatus passage (60.4 +/- 12.4 h), hospitalization (11.0 +/- 1.5 days), and the degree of postoperative pain (3.5 +/- 0.6, visual analogue scale). D3 lymphadenectomy resulted in the harvest of ample lymph nodes (24.6 +/- 4.5) for histopathological examinations and facilitated the upstaging of three (5.6%) patients. CONCLUSION: D3 lymph node dissection by the laparoscopic approach can be safely and efficiently performed for male rectosigmoid cancer with quick convalescence.
机译：背景：腹腔镜D3淋巴结清扫术是一项具有挑战性的外科手术，以前尚未见报道。本研究旨在测试此程序的技术可行性。方法：选择54例临床分期为III期直肠乙状结肠癌的男性患者，进行腹腔镜D3淋巴结清扫术。除标准前切除术中的肠系膜清扫术外，D3直肠乙状结肠癌淋巴结清扫术的范围还包括双侧common总动脉和静脉的骨骼化以及腹主动脉向上至十二指肠第三部分和左肾静脉的水平。对患者进行了手术可行性，效率和结果的前瞻性随访。结果：腹腔镜D3淋巴结清扫术治疗直肠乙状结肠癌的手术时间（303.4 +/- 35.8分钟，平均+/-标准偏差）可以接受，并且通过小伤口的出血量适中（344.8 +/- 50.6 ml）。术后30天内无死亡，并发症发生率为20.4％。通过肠胃气道的恢复（60.4 +/- 12.4小时），住院（11.0 +/- 1.5天）和术后疼痛程度（3.5 +/- 0.6），视觉模拟量表评估，患者的功能恢复很快）。 D3淋巴结清扫术收集了大量淋巴结（24.6 +/- 4.5）用于组织病理学检查，并促进了三名（5.6％）患者的分期。结论：腹腔镜下D3淋巴结清扫术能快速有效地治疗男性直肠乙状结肠癌。

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