残胃复发癌治疗策略  

Treatment strategies for gastric stump cancer

作　　者：胡祥[1] 

机构地区：[1]大连医科大学附属第一医院普通外科,辽宁大连116011

出　　处：《中国实用外科杂志》2015年第10期1075-1078,共4页Chinese Journal of Practical Surgery

摘　　要：残胃复发癌的治疗策略取决于癌的浸润深度。内镜下黏膜切除术(EMR)、内镜黏膜下剥离术(ESD)适应证以外的早期残胃癌原则上应行全胃切除术;黏膜内癌应行D1或D1+淋巴结清扫术;黏膜下层癌应行D1+或D2淋巴结清扫术;缝合部位或吻合口癌应行D2淋巴结清扫术。进展期残胃癌应行全胃切除术和D2淋巴结清扫术。对于能治愈性切除的进展期T3或T4残胃癌,按淋巴流向及淋巴结转移规律行D2+、16a2b1淋巴结清扫术,必要时合并脏器切除。The treatment strategies of gastric stump cancer are mainly based on the depth of tumor invasion. For early gastric stump cancer incompatible with endoscopic mucosal resection （EMR） and endoscopic submucosal dissection （ESD）, the total gastric resection is employed. The extent of lymph node dissection of intramucosal carcinoma is D1/D1 ＋, and D1 ＋/D2 for submucosal carcinoma, D2 for sutures or anastomotic carcinoma. The treatment principle for advanced gastric stump cancer is total gastric resection and D2 lymph node dissection. On the basis of lymph flow and metastatic regulation, D2＋ lymph node dissection, 16a2bl resection and essential combined organ resection should be applied to curatively resectable advanced gastric stump cancer of stage T3 or T4.

关 键 词：残胃癌 淋巴流 淋巴结转移 

分 类 号：R6[医药卫生—外科学]