胃癌的淋巴结转移与清扫研究进展  

Advances of Lymphatic Metastasis and Lymphadenectomy in Gastric Cancer

作　　者：宋鹏[1] 吴蕾[1] 

机构地区：[1]南京医科大学第一临床医学院,江苏南京210029

出　　处：《中国普外基础与临床杂志》2012年第1期116-121,共6页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结并分析目前胃癌外科手术中关于淋巴结转移与清扫的不同观点。方法对当前国内外有关胃癌淋巴结转移与清扫方法的研究报道进行综述和分析。结果胃癌周围淋巴结清扫是根据临床分期和肿瘤的位置整块清除周围淋巴结;腹腔镜下胃癌根治术安全、可行、有效、创伤小且近期、远期效果良好;前哨淋巴结在临床上应用于对早期胃癌的评估是可行的,准确率和敏感性均较高;胃癌周围淋巴结显像是一种有效、易行和安全的方法,对胃癌淋巴结清扫有指导作用;胃癌的循证外科治疗给淋巴结清扫的范围提供了一个新的视角。结论精确评估各种清扫方法是困难和复杂的,需要世界范围内的胃肠外科学者加强合作,互相取长补短,进行深入研究,这样才能得出令人信服的一致结论,并最终形成临床实践的指导原则。Objective To summarize and analyze the different views on the lymph node metastasis and the extent of lymphadenectomy in gastric cancer.Methods The current domestic and foreign reports on lymph node metastasis and lymphadenectomy in gastric cancer were reviewed.Results Lymph node dissection of gastric cancer is based on clinical stage and the location of the tumor.Laparoscopic-assisted gastrectomy in treatment of gastric cancer is a safe,feasible,effective,and minimally invasive technique with good outcomes for patients.Sentinel lymph node（SLN） in the clinical assessment of early gastric cancer is feasible,besides with high accuracy and sensitivity.Lymphatic mapping is an effective,easy,and safe method to guide lymphadenectomy in gastric cancer.Evidence-based lymphadenectomy in gastric cancer provide a new perspective to the extent.Conclusions It is difficult to evaluate those methods exactly.Researchers over the world should learn from each other and explore further in order to develop guiding principles in the end.

关 键 词：胃癌 淋巴结转移 淋巴结清扫 腹腔镜 前哨淋巴结 淋巴结显像技术 循证外科 

分 类 号：R735.2[医药卫生—肿瘤]