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[肠系膜解剖学理论指导下胃癌根治术中的幽门下淋巴结清扫术]

[Infrapyloric lymph node dissection in gastric cancer radical surgery under the guidance of mesenteric anatomy theory].

作者信息

Hu J K, Zhang W H

机构信息

Department of Gastrointestinal Surgery, Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2019 May 25;22(5):413-417. doi: 10.3760/cma.j.issn.1671-0274.2019.05.003.

Abstract

The most common metastasis modality of gastric cancer is the perigastric lymph node metastasis. Complete dissection of regional lymph nodes of the stomach is the core surgical treatment strategy of gastric cancer, and is closely related to the prognosis of gastric cancer patients. Infrapyloric lymph node metastasis is common in gastric cancer,and its incomplete dissection is associated with tumor recurrence. Meanwhile, anatomical variations of vessels and complex mesentery layers of infrapyloric area increase the difficulty of lymphadenectomy during the operation. So, infrapyloric lymph node (No. 6) is an important station. Based on the theory of embryonic development and complete mesogastrium excision, operation across the anatomical space among mesentery layers can ensure en bloc resection of the infrapyloric lymph nodes.

摘要

胃癌最常见的转移方式是胃周淋巴结转移。完整清扫胃区域淋巴结是胃癌外科治疗的核心策略,与胃癌患者的预后密切相关。幽门下淋巴结转移在胃癌中较为常见,其清扫不彻底与肿瘤复发相关。同时,幽门下区域血管的解剖变异和复杂的系膜层次增加了手术中淋巴结清扫的难度。因此,幽门下淋巴结(第6组)是一个重要的分站。基于胚胎发育理论和完整胃系膜切除,跨系膜层间解剖间隙操作可确保幽门下淋巴结的整块切除。

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