保留脾脏的脾门淋巴结清扫在根治性全胃切除术中的临床应用  

Clinical application of splenic hilar lymphadenectomy with spleen preservation in radical total gastrectomy for gastric carcinoma

作　　者：沈阳[1] 曾永庆[1] 文刚[1] SHEN Yang;ZENG Yongqing;WEN Gang(Department of Gastrointestinal Surgery, The First People's Hospital of Hefei y Hefeiy Anhui 230001, China)

机构地区：[1]合肥市第一人民医院胃肠外科,安徽合肥230001

出　　处：《安徽医药》2017年第8期1410-1412,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨根治性全胃切除术中保留脾脏的脾门淋巴结清扫的可行性及安全性。方法回顾性分析22例根治性全胃切除术中采用保留脾脏的脾门淋巴结清扫的病人临床资料,并与同期行脾脏切除组26例病人临床资料相对比。结果保脾组22例手术均顺利完成,无中转切脾病例。保脾组与切脾组手术时间分别为(4.8±0.5)、(4.6±0.7)h,术中出血量分别为(82.9±30.3)、(81.3±29.8)m L,脾门淋巴结阳性率分别为18.2%、19.2%,两组比较差异无统计学意义(P>0.05),而住院时间分别为(10.8±1.6)、(14.1±3.2)d,术后并发症发生率分别为4.5%、15.4%,差异有统计学意义(P<0.05)。结论根治性全胃切除术中保留脾脏的脾门淋巴结清扫安全可行,外科医生应努力提高手术技巧,减少无辜性脾切除。Objective To investigate the feasibility and safety of splenic hilar lymph node dissection in radical total gastrectomy.Methods A retrospective analysis was carried out in22cases underwent splenic hilar lymph node dissection in radical total gastrectomy and26cases underwent splenectomy.Results Spleen preserving group was successfully completed in22cases,with no intraoperative transfer of splenectomy cases.The operation times were(4.8±0.5)h and(4.6±0.7)h,the intraoperative bleeding volumes were(82.9±30.3)mL and(81.3±29.8)mL,and splenic hilar lymph node positive rates were18.2%and19.2%in spleen preserving group and splenectomy group.There were no significant differences between the two groups(P>0.05).The lengths of hospital stay were(10.8±1.6)d and(14.1±3.2)d,and the postoperative complication rates were4.5%and15.4%,in which the difference was statistically significant^P<0.05).Conclusion Spleen-preserving splenic hilar lymphadenectomy is a feasible and safe method to accomplish radical lymphadenectomy in total gastrectomy for gastric carcinoma.Surgeons should master excellent surgical techniques to perform anatomical lymph node dissection and unnecessary splenectomy be avoided.

关 键 词：胃癌 保留脾脏 脾门淋巴结清扫 全胃切除 

分 类 号：R735.2[医药卫生—肿瘤]