Herbella Fernando A M, Lourenço Laercio G, Bonini Andre L, Schlottmann Francisco, Patti Marco G
Esophagus and Stomach Division, Department of Surgery, Escola Paulista de Medicina, São Paulo, Brazil.
University of North Carolina at Chapel Hill, Chapel Hill.
Clin Anat. 2019 Jan;32(1):9-12. doi: 10.1002/ca.23241. Epub 2018 Sep 3.
Lymphadenectomy is a crucial part of the surgical therapy for gastric cancer. The number of normal lymph nodes could indicate the number of nodes that need to be retrieved during the procedure. The aim of this study is to analyze the number of lymph nodes in cadavers without gastric cancer according to the Japanese Gastric Cancer Association guidelines. Twenty fresh adult cadavers (14 males, mean age 55, range 24-93 years) were used. Abdominal lymph nodes were dissected and classified according to the Japanese Gastric Cancer Association. For total gastrectomy, the median number of lymph nodes that comprised D1 + dissection was 27 (range 15-42). The median and mean number of lymph nodes that comprised D2 dissection was 33, ranging from 18 to 50. For distal gastrectomy, the D1 + level comprised a median of 21 lymph nodes (range 11-38), and the D2 level 22 lymph nodes (range 11-39). In conclusion, considering gastrectomy + D2 lymphadenectomy as the standard treatment for gastric cancer, our results show that adequate lymphadenectomy must encompass around 30 lymph nodes. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.
淋巴结清扫术是胃癌外科治疗的关键部分。正常淋巴结的数量可表明手术过程中需要切除的淋巴结数量。本研究的目的是根据日本胃癌协会指南分析无胃癌尸体的淋巴结数量。使用了20具新鲜成人尸体（14例男性，平均年龄55岁，范围24 - 93岁）。腹部淋巴结根据日本胃癌协会进行解剖和分类。对于全胃切除术，构成D1 +清扫的淋巴结中位数为27个（范围15 - 42个）。构成D2清扫的淋巴结中位数和平均数为33个，范围为18 - 50个。对于远端胃切除术，D1 +级别的淋巴结中位数为21个（范围11 - 38个），D2级别的淋巴结为22个（范围11 - 39个）。总之，将胃切除术 + D2淋巴结清扫术视为胃癌的标准治疗方法，我们的结果表明，充分的淋巴结清扫术必须包括约30个淋巴结。《临床解剖学》，2018年。© 2018威利期刊公司。
