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| 1 | 全结肠系膜切除术与传统结肠癌根治术在右半结肠癌手术中的对比研究显示文摘目的探讨右半结肠癌开腹CME术的短期疗效和安全性。方法回顾分析2010年12月至2012年12月由同一组手术医师收治的76例行CME术的右半结肠癌患者临床资料,并与2009年1月至2010年11月由同一组手术医师收治的65例行传统结肠癌根治术的右半结肠癌患者比较短期疗效和安全性。结果 CME组手术时间较传统手术组稍长,2组比较差异有统计学意义(P=0.004),术中出血量比较差异无统计学意义(P=0.421);CME组清扫淋巴结总数、切除肠管长度较传统手术组多,2组比较差异有统计学意义(P<0.001,P=0.004),2组的阳性淋巴结比较差异无统计学意义(P=0.070);术后排气时间、住院时间、术后并发症比较差异均无统计学意义(分别为P=0.082,P=0.183,P=0.562)。规律随访后所有患者均存活,CME组局部复发率为5.26%明显低于传统开腹组13.84%(P=0.036);CME组的远期转移率为6.58%,与传统开腹组6.15%比较差异无统计学意义(P=0.918)。结论对于右结肠癌根治术而言,CME术是一种短期疗效好而且安全的手术方式。 | 张文斌 李翔 | 2013 | 南昌大学学报(医学版)2013，53，12： | 16 |
| 2 | 纳米碳淋巴示踪剂在乙状结肠癌及高位直肠癌腹腔镜根治术中的应用显示文摘目的:探讨纳米碳淋巴示踪剂在乙状结肠癌及高位直肠癌腹腔镜根治术中的临床应用价值。方法:回顾分析2010年5月至2016年12月为153例乙状结肠癌及高位直肠癌患者行腹腔镜根治术的临床资料,59例患者术前1 d肠镜下于肿瘤周围注射纳米碳(观察组),94例患者直接手术(对照组);分析比较两组大体标本情况及淋巴结检出情况。结果:与对照组相比,观察组标本长度较短[(17.8±5.3)cm vs.(19.7±4.2)cm,P=0.020],近切缘距肿瘤距离较短[(7.3±3.7)cm vs.(8.6±3.3)cm,P=0.028)],远切缘距肿瘤距离较短[(4.7±1.8)cm vs.(5.7±2.6)cm,P=0.014)],淋巴结检出数量较多[(16.9±6.5)vs.(11.2±5.9),P<0.001],淋巴结<12枚比例较低(13.6%vs.59.6%,P<0.001)。结论:腹腔镜乙状结肠癌及高位直肠癌腹腔镜根治术中应用纳米碳淋巴示踪技术有助于指导合理选择手术切除范围,提高淋巴结检出率,具有较高的临床应用价值。 | 鲍峰 李国强 邓志刚 向春华 向荣超 智星 刘文 柳万忠 龙煊 | 2017 | 腹腔镜外科杂志2017，22，8： | 6 |
| 3 | Colorectal cancer and lymph nodes:The obsession with the number 12显示文摘Lymphadenectomy of colorectal cancer is a decisive factor for the prognostic and therapeutic staging of the patient.For over 15 years,we have asked ourselves if the minimum number of 12 examined lymph nodes(LNs)was sufficient for the prevention of understaging.The debate is certainly still open if we consider that a limit of 12 LNs is still not the gold standard mainly because the research methodology of the first studies has been criticized.Moreover many authors report that to date both in the United States and Europe the number'12'target is uncommon,not adequate,or accessible only in highly specialised centres.It should however be noted that both the pressing nature of the debate and the dissemination of guidelines have been responsible for a trend that has allowed for a general increase in the number of LNs examined.There are different variables that can affect the retrieval of LNs.Some,like the surgeon,the surgery,and the pathology exam,are without question modifiable;however,other both patient and disease-related variables are non-modifiable and pose the question of whether the minimum number of examined LNs must be individually assigned.The lymph nodal ratio,the sentinel LNs and the study of the biological aspects of the tumor could find valid application in this field in the near future. | Giovanni Li Destri Isidoro Di Carlo Roberto Scilletta Beniamino Scilletta Stefano Puleo | 2014 | World Journal of Gastroenterology2014，20，8： | 4 |
| 4 | 阳性淋巴结比值比在预测术前放化疗后直肠癌术后患者生存的价值显示文摘目的分析阳性淋巴结比值比(LNR)在预测术前放化疗(CRT)后直肠癌术后患者生存的价值。方法 133例局部进展期直肠癌患者,给予术前放化疗后进行了全直肠系膜切除术(TME),根据术后病理LNR将患者分成LNR=0、0 | 陈力 黄学锋 | 2019 | 中国实用医药2019，14，1： | 3 |
| 5 | 结直肠癌术前淋巴结CT量化分析显示文摘目的探讨术前采用CT薄块最大强度投影(MIP)技术对结直肠癌(CRC)手术切除范围内淋巴量化分析,对提高病理检出率及提高CRC患者N分期准确性的价值。方法回顾性分析2013年4月至2016年1月经南京医科大学附属无锡二院手术的123例CRC资料。所有患者术前作CT双期增强检查后行肿瘤开腹切除。CT检查与手术间隔6.5 d(3~15 d)。采用CT薄块(5 mm)MIP技术连续采集切除区域冠状位图像后,使用透明网格薄膜(每格1 cm×1 cm)贴于显示屏上后调整图像比例尺刻度(每格1 cm)与薄膜小格一致,并由前往后逐层勾画标准手术切除区域内淋巴结分布、大小,最后依据实际手术切除标本范围和记录统计该区域淋巴结总数并与病理淋巴结检出数进行比较。结果 123例CRC中,CT淋巴结识别数共2 901枚,每例患者检出4~47(23.59±9.90)枚;病理检出2 063枚,每例患者检出4~37(16.77±9.36)枚,两者差异有统计学意义(P<0.05)。其中升结肠癌组、横结肠癌组、降结肠癌组、乙状结肠癌组及直肠组CT淋巴结识别数分别为(28.69±7.98)枚、(41.50±4.93)枚、(19.50±8.22)枚、(19.71±8.33)枚及(19.57±8.54)枚;对应病理检出数分别为(21.77±8.98)枚、(29.50±8.22)枚、(8.50±4.93)枚、(14.29±6.68)枚及(12.24±9.55)枚。CT识别淋巴结总数、每例数目及各种CRC数目均高于病理检出数,差异有统计学意义(P均<0.05)。结论采用CT薄块MIP技术用于CRC术前切除区域淋巴结数目评价是可行的。鉴于CT检出淋巴结平均数高于病理检出,可有助于病理上检出更多淋巴结,从而提高CRC患者N分期的准确性。 | 巫丹萍 卞琳杰 张追阳 陆风旗 孙晓光 唐威 | 2018 | 中国临床研究2018，31，2： | 2 |
| 6 | 体质量指数对结直肠癌切除术中淋巴结检测数目的影响显示文摘目的:探讨体质量指数(body mass index,BMI)对结直肠癌切除术淋巴结检测数目的影响。方法:回顾性分析自2014年12月至2017年1月福建省立医院收治的328例结直肠癌患者的临床病理资料,全部患者均行结直肠癌切除术,以术后病理的淋巴结检测数目为依据分为两组(<12枚组与≥12枚组),将各组的临床病理因素进行统计学分析。结果:单因素分析显示,患者的BMI(χ^2=7.697,P=0.006)、肿瘤部位(χ^2=7.900,P=0.048),肿瘤TNM分期(χ^2=34.795,P<0.010)等因素在两组间的淋巴结检测数目方面差异具有统计学意义;Logistic回归分析提示,根据世界卫生组织(WHO)标准(正常值范围:18.5~24.9 kg/m^2)对BMI进行分组,BMI≥25 kg/m^2组与BMI<25 kg/m^2组相比,淋巴结检测数目<12枚的风险显著增加(OR=2.557,95%CI:1.231~5.309;P=0.012)。肿瘤位于直肠、乙状结肠的患者与其他部位患者相比,淋巴结检测数目<12枚的风险显著增加(OR=1.731,95%CI:1.066~2.810;P=0.027)。结论:高BMI指数可影响结直肠癌手术中是否获取足够的淋巴结检测数目,进而影响其术后病理分期。 | 林达佳 吴健生 薛芳沁 陈林昊 曾长青 | 2019 | 中国肿瘤临床2019，46，16： | 1 |
| 7 | Digestive cancer surgery in the era of sentinel node and epithelial-mesenchymal transition显示文摘Lymph node involvement is one of the most important prognostic indicators of carcinoma of the digestive tract.Although the therapeutic impact of lymphadenectomy has not been proven and the number of retrieved nodes cannot be considered a measure of successful cancer surgery,an adequate lymph node count should be guaranteed to accurately assess the N-stage through the number of involved nodes,lymph node ratio,number of negative nodes,ratio of negative to positive nodes,and log odds,i.e.,the log of the ratio between the number of positive lymph nodes and the number of negative lymph nodes in digestive carcinomas.As lymphadenectomy is not without complications,sentinel node mapping has been used as the rational procedure to select patients with early digestive carcinoma in whom nodal dissection may be omitted or a more limited nodal dissection may be preferred.However,due to anatomical and technical issues,sentinel node mapping and nodal basin dissection are not yet the standard of care in early digestive cancer.Moreover,in light of the biological,prognostic and therapeutic impact of tumor budding and tumor deposits,two epithelial-mesenchymal transition-related phenomena that are involved in tumor progression,the role of staging and surgical procedures in digestive carcinomas could be redefined. | Nadia Peparini | 2013 | World Journal of Gastroenterology2013，19，47： | 0 |
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