[右侧结肠癌外科治疗中国专家共识(2024 年版)]。

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引用次数: 0

摘要

近二十年来,随着腹腔镜技术的发展和应用,以及全系膜切除理念的推广,右半结肠癌的外科治疗发生了重大变化。中华医学会结直肠外科学分会和中国结直肠研究联盟(CCRC)组织全国结直肠外科专家,结合我国医生和患者的偏好以及干预措施的利弊,就右半结肠切除术相关的 14 个关键临床问题形成共识,以期规范右半结肠癌的外科治疗。共识建议主要集中在三个方面:(1)手术解剖:明确了肠系膜和血管解剖相关的关键结构及其定义。建议将肠系膜上动脉左侧作为完整切除肠系膜的内侧边界;(2)手术技术:建议将腹腔镜作为右侧结肠癌的首选手术方法;(3)手术原则:D2 淋巴结清扫术可视为右侧结肠癌的标准治疗方法。除非术前造影或术中探查发现疑似区域淋巴结转移,否则可将标准 D2 作为常规手术。除非怀疑有转移,否则不建议切除幽门下淋巴结。此外,还就血管结扎的位置、肠切除范围和吻合技术提出了共识性建议。
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[Chinese expert consensus on the surgical treatment of right-sided colon cancer (2024 edition)].

In the past two decades, with the development and application of laparoscopic technique and the promotion of the concept of complete mesocolic excision, significant changes have occurred in the surgical treatment of right-sided colon cancer. The Chinese Society of Colorectal Surgery and Chinese Colorectal Research Consortium (CCRC) Organized national experts in colorectal surgery to form a consensus on 14 key clinical issues related to right hemicolectomy, taking into account the preferences of Chinese doctors and patients as well as the pros and cons of intervention measures, with a view to standardizing the surgical treatment of right colon cancer. The consensus recommendations were focused on three main aspects: (1) surgical anatomy: the key structures and its definitions related to the mesentery and vascular anatomy were clarified. It is recommended that the left side of the superior mesenteric artery be considered the medial boundary for complete mesocolic excision; (2) surgical technique: laparoscopy is recommended as the preferred surgical approach for right-sided colon cancer; (3) surgical principles: D2 lymph node dissection could be considered as the standard of care for right-sided colon cancer. Standard D2 could be considered as routine procedure unless preoperative imaging or intraoperative exploration revealed suspected regional lymph node metastasis. Dissection of infrapyloric lymph node is not recommended unless it is suspected as metastasis. Additionally, consensus recommendations were made regarding the location of vascular ligation, the extent of bowel resection, and anastomosis techniques.

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来源期刊
中华胃肠外科杂志
中华胃肠外科杂志 Medicine-Medicine (all)
CiteScore
1.00
自引率
0.00%
发文量
6776
期刊介绍:
期刊最新文献
[Completely laparoscopic radical treatment of distal gastric cancer through natural orifice specimen extraction surgery: past, present, and future]. [From following to surpassing: insight into GIST treatment development in China]. [Onco-metabolic surgery: the bridge between curative resection of gastric cancer and the remission of type 2 diabetes mellitus]. [Long-term prognosis of surgical treatment for peri-gastric cardial gastrointestinal stromal tumors]. [Relationship between ripretinib concentration and the prognosis of advanced gastrointestinal stromal tumors in China: a multicenter study].
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