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淋巴结转移是直肠癌复发的主要原因之一。Miles很早就指出:“不论直肠癌的部位,其壁外的淋巴扩散有向上方,侧方及下方三个途径。”多年来,很多学者根据这一观点,对于直肠癌进行了这三个方向的清扫。但是,五十年代以来,Deddish,Stearns等人认为,作为直肠扩大根治术一环的侧方淋巴结清扫的效果并不好。欧美学者受此观点影响较深,多数学者认为直肠癌的淋巴结转移主要是向上方,而侧,下方转移占次要地位,认为并无一律进行三方清扫的必要。近年来,许多日本学者则认为三方向的淋巴结转移均占一定的比例,主张进行三方清
Lymph node metastasis is one of the major causes of rectal cancer recurrence. Miles pointed out very early: “Regardless of the location of rectal cancer, lymphatic proliferation outside the wall has upward, lateral and inferior pathways.” Over the years, many scholars have carried out these three studies on rectal cancer. Direction of cleaning. However, since the 1950s, Deddish, Stearns, and others believe that the effectiveness of lateral lymph node dissection as a part of the extended radical resection of the rectum is not good. European and American scholars are deeply influenced by this view. Most scholars believe that the lymph node metastasis of rectal cancer is mainly upward, while the lateral and inferior metastases occupy a minor position, and it is believed that there is no need for a tripartite sweep. In recent years, many Japanese scholars believe that the three directions of lymph node metastasis account for a certain proportion, and advocate the tripartite clearance.