系膜解剖理论指导下胃癌根治手术的幽门下区域淋巴结清扫  

Infrapyloric lymph node dissection in gastric cancer radical surgery under the guidance of mesenteric anatomy theory

作　　者：胡建昆[1] 张维汉[1] Hu Jiankun;Zhang Weihan(Department of Gastrointestinal Surgery, Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院胃肠外科中心胃癌研究室,成都610041

出　　处：《中华胃肠外科杂志》2019年第5期413-417,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金项目(81372344);四川省干部保健科研课题项目(川干研2017-114);华西医院学科卓越发展1.3.5工程(ZY2017304).

摘　　要：胃癌最主要转移方式是胃周淋巴结转移,彻底清扫胃周淋巴结是胃癌外科治疗的核心之一。完整而彻底地清扫胃周区域淋巴结,与胃癌患者预后密切相关。幽门下区域淋巴结转移常见,加之该区域血管解剖变异较多、且系膜层次复杂,对手术技术要求较高。若未彻底清扫该区域淋巴结,会有导致肿瘤复发的可能。因此,幽门下区域淋巴结(No.6)是胃癌D2根治术中比较重要的一组淋巴结。基于胚胎发育及系膜解剖理论,经系膜解剖间隙进行幽门下区域淋巴结清扫,可以保证彻底完整切除幽门下区域淋巴结。The most common metastasis modality of gastric cancer is the perigastric lymph node metastasis. Complete dissection of regional lymph nodes of the stomach is the core surgical treatment strategy of gastric cancer, and is closely related to the prognosis of gastric cancer patients. Infrapyloric lymph node metastasis is common in gastric cancer,and its incomplete dissection is associated with tumor recurrence. Meanwhile, anatomical variations of vessels and complex mesentery layers of infrapyloric area increase the difficulty of lymphadenectomy during the operation. So, infrapyloric lymph node (No. 6) is an important station. Based on the theory of embryonic development and complete mesogastrium excision, operation across the anatomical space among mesentery layers can ensure en bloc resection of the infrapyloric lymph nodes.

关 键 词：胃肿瘤 胃系膜 淋巴结清扫 幽门下淋巴结 

分 类 号：R735.2[医药卫生—肿瘤]