胃癌根治术中№12a淋巴结清扫60例分析  

Analysis of №12a lymph node dissection for 60 cases of advanced gastric cancer

作　　者：缪文忠[1] 孙金兵[1] 蒋建龙[1] 

机构地区：[1]苏州大学附属常熟市第一人民医院普外科,江苏常熟215500

出　　处：《徐州医学院学报》2013年第8期522-524,共3页Acta Academiae Medicinae Xuzhou

摘　　要：目的 回顾性分析胃癌根治术中№12a淋巴结清扫方法和意义.方法 对60例进展期胃癌患者行胃癌根治术中№12a淋巴结清扫的临床资料进行回顾性分析.结果 平均清扫№12a淋巴结 （2.4±0.6）个,术后病理检查显示№12a淋巴结转移率为26.67%（16/60）.本组60例胃癌患者术后未出现吻合口漏、胆漏、术后肝功能明显异常、术后出血等相关并发症.术中选择Kocher切口翻转胰腺和十二指肠,自上而下骨骼化肝固有动脉、胆总管、门静脉,清晰显露＂三管结构＂是彻底清扫№12a淋巴结的必要步骤.结论 熟悉肝十二指肠韧带解剖,实施肝固有动脉鞘内清扫可彻底清扫№12a淋巴结.№12a淋巴结清扫术是安全、可行的.Objective To investigate the significance and surgical skill for lymphadenectomy of No. 12a lymph nodes in gastric cancer. Methods The clinical data of 60 cases of advanced gastric cancer undergoing lymphadenectomy of No. 12a lymph nodes were analyzed retrospectively. Results The number of dissected No. 12a lymph nodes was （2.4 ±0.6） in 60 patients with advanced gastric cancer, and pathological observation showed that the rate of positive lymph nodes of No. 12a was 26.67% （16/60）. There were no lymphadenectomy related complications, such as anastomotic leakage, bile leakage, obvious abnormal postoperative liver function, and postoperative bleeding. Selecting Kocher inci- sion in order to reflect the pancreas and duodenum, skeletonizing proper hepatic artery, bile duct and portal vein from top to bottom in order to clearly show the ＂three - duct structure＂ in the operation were the key steps for the complete lymph-adenectomy of No. 12a lymph nodes. Conclusion Being familiar with the anatomy of the hepatoduodenal ligament and intrathecal dissection of proper hepatic artery can guarantee the complete dissection of No. 12a lymph nodes. The dissec-tion of No. 12a lymph nodes is feasible and safe.

关 键 词：进展期胃癌 淋巴结清扫 

分 类 号：R735.2[医药卫生—肿瘤]