腹腔镜胃癌D2根治术中腹腔干淋巴结清扫策略及技巧  

Strategies and techniques of abdominal trunk lymph node dissection in laparoscopic D2 radical gastrectomy for gastric cancer

作　　者：李春兴[1] 张文斌[1] 许新才[1] 高华[1] 何铁汉[1] 张慧慧 LI Chunxing;ZHANG Wenbin;XU Xincai;GAO Hua;HE Tiehan;ZHANG Huihui(Department of Gastrointestinal Tumors,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,830054,China;Department of Comprehensive Outpatient,The Twelfth Division of Xinjiang Production and Construction Corps,Urumqi,830009,China)

机构地区：[1]新疆医科大学第一附属医院胃肠(肿瘤)外科,乌鲁木齐830054 [2]新疆生产建设兵团第十二师综合门诊部,乌鲁木齐830009

出　　处：《新疆医学》2020年第10期1042-1045,1037,共5页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(项目编号:2017D01C305)。

摘　　要：胰腺上缘区域的淋巴结是胃癌D2根治术淋巴结清扫的核心所在,尤其是腹腔干周围的淋巴结清扫,是清扫的难点所在。本文通过总结我中心自2018年11月至今,逐渐摸索胰腺上区的淋巴结清扫方法,尤其是在腹腔干淋巴结清扫方面做了改良措施,即幽门上淋巴结清扫先离断十二指肠、腹腔干淋巴结清扫先离断胃左动脉后离断冠状血管,顺势将腹腔干右侧的"盲区"提拉上来一并清扫。通过不断改进腹腔干淋巴结清扫的方法,使得胰腺上区淋巴结清扫更加安全和规范,并希望此改进方法为腹腔干淋巴结清扫提供借鉴和指导。The lymph nodes in the upper edge of pancreas are the core of lymph node dissection in D2 radical gastrectomy for gastric cancer,especially the lymph nodes around the abdominal trunk.In this paper,from November 2018 to now,our center has gradually explored the method of lymph node dissection in the upper pancreatic region,especially in the abdominal trunk lymph node dissection,which means that the duodenum should be cut off first,the left gastric artery and then the coronary artery should be cut off before the abdominal trunk lymph node dissection,and the"blind area"on the right side of the abdominal trunk will be lifted up and cleaned together.Through continuous improvement of the method of celiac trunk lymph node dissection,making the upper pancreatic lymph node dissection more safe and standardized,and hope this improved method can provide reference and guidance for abdominal trunk lymph node dissection.

关 键 词：胃肿瘤 腹腔镜D2根治 胰腺上区 淋巴结清扫 腹腔干 

分 类 号：R735.2[医药卫生—肿瘤]