右側結腸癌のリンパ節移転および再発形式から見たリンパ節郭清範囲の選択

Indication of Laparoscopy-assisted Colectomy and Para-aortic Lymph Node Dissection in Right Colon Cancer

Creators Adachi Tadafumi

Creators Hazama Syoichi

Creators Yoshimura Kiyoshi

Creators Oka Masaaki

We investigated histopathologic findings and lymph node recurrence in right colon cancer to evaluate the indication for laparoscopy-assisted colectomy and para-aortic lymph node dissection. Forty-six patients who had undergone curative resection for right colon cancer in a recent one decade were studied. Tumors with invasion into the colonic wall no deeper than the proper muscle layer (n = 13) were not associated with lymph node metastasis. Patients whose primary lesions were smaller than 20 mm in maximum diameter had no lymph node metastasis. Patients with 0 or 1 macroscopic type also had no lymph node metastasis. These patients may be candidates for laparoscopy-assisted colectomy. Lymph node metastases of n0, n1, n2, and n3 were observed in 28, 4, 13, and I patients, respectively. All of 8 patients who experienced tumor recurrence had n2 or n3 lymph node metastasis. Out of these 8 patients, 2 patients had only para-aortic lymph node recurrence. Preventive para-aortic lymph node dissection is therefore suitable for right colon cancer with n2 or n3 lymph node metastasis.

[ISSN]0513-1731

[NCID]AN00243156