中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

根治性肺癌切除术中淋巴结切除的质量控制

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淋巴结清扫是肺癌根治标准手术中必不可少的环节。淋巴结清扫质量决定了手术完整切除的程度及淋巴结分期的准确性。第 8 版肺癌 TNM 分期对淋巴结分期给出了明确的定义。由此,我们建议根据该分期对术中清扫淋巴结进行标记。系统性淋巴结清扫仍是淋巴结切除的金标准,应至少切除纵隔 3 站共不少于 10 个淋巴结,并尽量行整块切除。根据现有回顾性证据,对于临床 Ⅰ 期肺癌,胸腔镜及机器人辅助腔镜下淋巴结清扫的肿瘤学预后与开放手术无显著性差异。在特定的早期患者中行选择性的有限淋巴结清扫还需要进一步临床证据验证。

As a standard of care, lymph node dissection is an indispensible step in lung cancer surgery. The quality of dissection determines completeness of surgery and the accuracy of N staging. Hereby, we suggest labeling all surgically resected nodes according to the new lymph node map in the 8th TNM classification for lung cancer. As systematic lymph n