Colon cancer is a commonly malignant tumor with high morbidity and mortality in China, which seriously threatens human health and lives. Surgery plays a key role in the treatment of colorectal cancer so far. The sigmoid colon is the predilection site of colon cancer. Laparoscopic surgery has been gradually applied in radical operation of sigmoid colon cancer. 4K laparoscopy belongs to a kind of high-imaging technology, of which the information volume is more than 4 times that of conventional high-definition televisions. It can improve the operator's sense of control on the surgical field of view. Combined with team practical experience, the author introduces and interprets the excision extent and operative procedures in radical resection of mid-distal sigmoid colon cancer from the perspective of the 4K laparoscopy.
Colon cancer is one of the common digestive system tumors, and its incidence has an increased tendency. Comprehensive treatment based on surgery is still the current treatment. Although the laparoscopic technology of colorectal surgery in China has been rapidly developed in the past 30 years, there is no unified concept for the principles of colon cancer treatment, the scope of lymph node dissection is controversial, and the surgical approach is not unified. The author provides a detailed interpretation of the Chinese and Japanese laparoscopic colon cancer surgical dissection guidelines and technical standards based on Chinese Expert Consensus on Operation Standard of 4K Laparoscopic Surgery for Colorectal Cancer (2020 Edition), The Japanese Classification of Colorectal, Appendiceal and Anal Carcinoma (9th edition), The Guidelines for the Treatment of Colorectal Cancer (2019 edition) and Guideline for Operative Procedure of Laparoscopic Radical Resection of ColorectaI Cancer (2018 edition).
目的 探讨术前外周血中性粒细胞与淋巴细胞比值(NLR)在胃癌根治术后患者预后中的评估作用.方法 选择2013年1月至2017年7月在新疆医科大学第一附属医院行R0胃癌根治术的166例胃癌患者为研究对象,全部患者术前行外周血细胞分类计数计算NLR,根据ROC曲线计算出NLR最佳临界点,将患者分为高NLR组(NLR≥1.74)117例,低NLR组(NLR<1.74)49例.比较两组患者临床病理特征和预后.结果 随访166例患者,其中低NLR组1年、3年生存率分别为91.84％、75.51％,高NLR组1年、3年生存率分别为90.60％、49.57％,单因素分析中维吾尔族、病理分型低分化组织类型、肿瘤N分期N1、N2、N3、TNM分期Ⅲ期、较高的NLR被确定为与总体生存期(OS)相关的不良预后因素;多因素分析中病理分型低分化组织类型、肿瘤T分期T3分期和NLR为与OS相关的独立预后因素.结论 术前NLR比值可作为R0胃癌根治术后患者生存率的独立预后因素,对评估患者预后有重要预测价值.
