刮吸解剖法在进展期胃癌淋巴结清扫术中的应用  

Application of Curettage and Aspiration Technique in Lymph Node Dissection for Advanced Gastric Cancer

作　　者：陈晓鹏[1] 李涛[1] 张国政[1] 张帆[1] 芮景[1] 李树仁[1] 

机构地区：[1]皖南医学院弋矶山医院,芜湖241001

出　　处：《中国现代手术学杂志》2007年第3期168-170,共3页Chinese Journal of Modern Operative Surgery

基　　金：安徽省临床医学重点学科项目基金资助(05A016)

摘　　要：目的　探讨刮吸解剖法在进展期胃癌淋巴结清扫术中的应用效果。方法　回顾性总结行刮吸法淋巴结清扫术的28例进展期胃癌患者的临床资料。行远端胃切除11例,近端胃切除11例（其中3例附加脾切除）,全胃切除6例（其中1例附加左肝外叶及双侧附件切除）。淋巴结清扫标准为D219例,选择性D39例。结果　所有手术均顺利完成,未发生血管损伤等严重并发症,术中平均出血290 m l。28例共清除淋巴结609枚,平均21.7枚/例。25例随访6-24月,7例复发,6例死亡（其中3例为复发者）,15例无瘤存活。结论　刮吸法行胃癌淋巴结清扫安全性高、出血量小、并发症少,淋巴结清扫和术后恢复均较满意,值得临床进一步探索和应用。Objective To explore the effect of curettage and aspiration technique in lymph node dissection for advanced gastric cancer. Method 19 cases of D2 and 9 cases of selective D3 radical resection were performed for advanced gastric cancer by using curettage and aspiration technique, including 11 of distal gas- trectomy, 11 of proximal gastric resection （3 cases of splenectomy in addition） , and 6 of total gastrectomy （ 1 case of left lateral lobectomy of liver and＇ bilateral adnexectomy in addition）. Results All operations were successfully finished without severe complication such as blood vessel injury. The average bleeding volume was 290 ml. The 609 lymph nodes were dissected from 28 patients with 21.7 nodes for each case averagely. In the 25 cases with 6 to 24 months follow-up,7 relapsed, 6 died（ including 3 of relapse） , and 15 tumor-free sur- vivecl. Conclusion Curettage and aspiration technique in the lymphadenectomy for advanced gastric cancer is recommendable with high safety, less blood loss, less complication, thorough lymph node dissection and good postoperative recovery, deserves to be further studied.

关 键 词：刮吸解剖法 胃肿瘤 淋巴结切除术 

分 类 号：R735.2[医药卫生—肿瘤]