恶性肿瘤淋巴结转移外科治疗的新趋向(3)

http://www.100md.com 2003年9月26日 好医生

     肿瘤治疗中，区域性淋巴结转移的正确处理对提高治愈率有很大影响。20世纪前50年肿瘤外科强调扩大整块切除肿瘤、牺牲器官功能以获取比较高的生存率。到近50年，注意到减少创伤，保全功能，在放疗或化疗等综合治疗条件下，在不影响生存率前提下，缩小手术范围，以保证维持或提高患者治疗后生存质量。患者如已有区域性淋巴结转移，应该手术清扫，必要时加以放射治疗。对于临床判断为N0，但其中有相当比例患者有潜在淋巴结转移者，应该如何处理，有不同见解。从主张全区域淋巴结清扫到局限性清扫，到前哨淋巴结检测，这是一个进步。这是临床肿瘤学的一百年间的一个变化。这是从伦理学考虑的一个概念的变化，也是长期经验和积累资料的实证显示。

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