Sawai K, Seiki K, Taniguchi H, Yokota T, Hagiwara A, Yamaguchi T, Takahashi T
First Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1310-3.
CH40 is five percent saline solution of the activated carbon particles with 20nm in diameter. It can absorb a large amount of ethanol. CH40 reach to the regional lymph nodes immediately after local injection, visualize the regional lymph nodes black in color and release ethanol in the metastatic lymph nodes. As the direction of lymph nodes staining was coincident with direction of metastasis, rationalization of lymph nodes dissection could be performed as follows: 1) When lymph nodes metastasis are found along the lesser curvature, dissection of lymph nodes in the hepatoduodenal ligament should be carried out. 2) When lymph nodes metastasis are found in the infrapyloric region, dissection of lymph nodes along the splenic artery, in the hepatoduodenal ligament, at the posterior aspect of the pancreas, and at the root of the mesenterium should be carried out. 3) When lymph nodes metastasis are found along the left gastric artery, the common hepatic artery, or the splenic artery, dissection of para-aortic lymph nodes should be carried out.
CH40是直径为20纳米的活性炭颗粒的5%盐溶液。它能吸收大量乙醇。局部注射后，CH40立即到达区域淋巴结，使区域淋巴结呈现黑色，并在转移淋巴结中释放乙醇。由于淋巴结染色方向与转移方向一致，淋巴结清扫的合理化可按以下方式进行：1）当沿小弯侧发现淋巴结转移时，应进行肝十二指肠韧带内淋巴结清扫。2）当在幽门下区域发现淋巴结转移时，应进行沿脾动脉、肝十二指肠韧带内、胰腺后方和肠系膜根部的淋巴结清扫。3）当沿胃左动脉、肝总动脉或脾动脉发现淋巴结转移时，应进行主动脉旁淋巴结清扫。
