Isozaki H, Okajima K, Fujiwara A, Yasuda M, Kawashima Y, Yamada S, Sakuramoto K
Dept. of Surgery, Osaka Medical College.
Gan No Rinsho. 1987 Dec;33(15):1886-91.
Gastric cancers that have invaded in the duodenum were clinicopathologically studied in 83 patients in an attempt to clarify surgical therapeutic problems. The classification and results are itemized below. 1) The extensive forms of these cancers were found to include the types of continual superficial extension (12 patients), expansion (11), deep-layer (39), whole-layer (9), non-continual extensive intralymphatic duct type (8) and specific type (4). 2) More patients manifesting a deep-layer or intralymphatic duct cancers were Borr. 3 and 4 types with a longer distance of infiltration. All of the 14 patients with an aw (+) showed these patterns of extension. 3) The n3 (+) was more common with Nos. 12, 13 and 14 lymph nodes, and similar results were seen by RI lymphography. Thus, special care may have to be exercised in treating the duodenal stump in the gastric cancers that have invaded the pyloric ring. Pancreato-duodenectomy may be required for the removal of lymph nodes in patients with gastric cancers that show a severe infiltration into the duodenum.
对83例侵犯十二指肠的胃癌患者进行了临床病理研究，以阐明手术治疗问题。分类及结果如下：1）这些癌症的广泛形式包括连续浅表扩展型（12例）、膨胀型（11例）、深层型（39例）、全层型（9例）、非连续广泛淋巴管型（8例）和特殊型（4例）。2）更多表现为深层或淋巴管癌的患者为Borrmann 3型和4型，浸润距离更长。14例aw（+）患者均表现出这些扩展模式。3）n3（+）在第12、13和14组淋巴结中更常见，放射性核素淋巴造影也有类似结果。因此，对于侵犯幽门环的胃癌，在处理十二指肠残端时可能需要特别小心。对于十二指肠浸润严重的胃癌患者，可能需要行胰十二指肠切除术以清除淋巴结。
