Okanobu K
First Department of Surgery, Okayama University Medical School, Japan.
Nihon Geka Gakkai Zasshi. 1990 Jul;91(7):808-17.
For the studies of the esophageal lymphatics, endoscopic RI-lymphoscintigraphy was performed in 23 cases of esophageal cancer, 3 cases of lung cancer and 5 cases of gastric cancer. 99mTc-Rhenium colloid was endoscopically injected into the submucosal layer of the esophagus near the tumor and the images of the lymph flow were obtained after about 3 hours. Single photon emission computerized tomography (SPECT) was used to acquire the three-dimensional images of the esophageal lymph flow on 19 patients. RI-uptake of all dissected lymph nodes was also counted after the operation. The results were shown as follows. 1. Whole neck, thoracic and abdominal lymph nodes could be imaged in any cases injected at any parts of the thoracic esophagus. But the lymph flow in the upper third of the esophagus tended to move mainly upward, and the lymph flow in the lower third tended to move mainly downward. 2. The block of intra-mural lymph vessels by the tumor had very important roles upon the esophageal lymph flow. 3. The removal of upper mediastinal lymph nodes and intraabdominal lymph nodes as well as paraesophageal lymph nodes seemed to be very important for curative resection of carcinoma of the esophagus.
为研究食管淋巴管，对23例食管癌、3例肺癌和5例胃癌患者进行了内镜放射性核素淋巴闪烁造影。在内镜下将99mTc - 铼胶体注入肿瘤附近食管的黏膜下层，约3小时后获取淋巴引流图像。对19例患者使用单光子发射计算机断层扫描（SPECT）获取食管淋巴引流的三维图像。术后还对所有切除的淋巴结进行了放射性核素摄取计数。结果如下：1. 在胸段食管任何部位注射的所有病例中，全颈部、胸部和腹部淋巴结均可显影。但食管上三分之一段的淋巴引流主要向上，下三分之一段的淋巴引流主要向下。2. 肿瘤对壁内淋巴管的阻塞对食管淋巴引流起非常重要的作用。3. 切除上纵隔淋巴结、腹腔淋巴结以及食管旁淋巴结似乎对食管癌的根治性切除非常重要。
