Huang Chang-ming, Lin Jian-xian
Department of Gastric Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Aug;15(8):784-6.
Splenic hilar lymph node (LN) should be removed in a D2 lymph node dissection for the advanced proximal gastric cancer. After improving the surgical technology and renewing treatment concepts, spleen-preserving splenic hilar LN dissection has been accepted by more and more surgeons. Because the anatomy position of spleen is very deep, and the splenic vessel is various, laparoscopic spleen-preserving splenic hilar LN dissection may be more difficult. In order to do better in laparoscopic spleen-preserving splenic hilar LN dissection, surgeons should choose the suitable patients; take reasonable surgical approach and surgical steps. Moreover, knowing the anatomy variance well of splenic vessel is also very important too.
对于进展期近端胃癌，在D2淋巴结清扫术中应切除脾门淋巴结。随着手术技术的改进和治疗理念的更新，保留脾脏的脾门淋巴结清扫术已被越来越多的外科医生所接受。由于脾脏的解剖位置很深，且脾血管情况多样，腹腔镜下保留脾脏的脾门淋巴结清扫术可能更具难度。为了更好地进行腹腔镜下保留脾脏的脾门淋巴结清扫术，外科医生应选择合适的患者；采取合理的手术入路和手术步骤。此外，充分了解脾血管的解剖变异也非常重要。
