Masuda F, Ohnishi T, Nakada J, Suzuki M, Mori Y, Iizuka N, Machida T
Hinyokika Kiyo. 1985 Apr;31(4):595-600.
The techniques, results and problems of lymphadenectomy were assessed in 56 cases of renal cell carcinoma. As the approach to the retroperitoneum, the thoracoabdominal approach was used in 22 cases and transabdominal approach in 34 cases. Radical nephrectomy was performed, followed by lymphadenectomy. All of the regional lymph nodes were dissected. The mean time required for lymphadenectomy was 1 hour and 40 minutes and the mean volume of blood loss was 350 ml. As intraoperative complications, vascular injury occurred in 3 cases. In 1 of these cases the left second lumbar vein was injured. Therefore, in lymphadenectomy caution should be exercised not to give injury to this blood vessel. The postoperative complication observed included bleeding and chylous ascites in 1 case each. In performing operations one must ligate the lymphatic vessel carefully. The 5-year-survival rate for 6 cases associated with metastasis to lymph node was 33%. From this fact, it was postulated that lymphadenectomy is helpful to improve prognosis of these patients.
对56例肾细胞癌患者的淋巴结清扫技术、结果及问题进行了评估。作为进入腹膜后的途径，22例采用胸腹联合切口，34例采用经腹切口。均行根治性肾切除术，随后进行淋巴结清扫。所有区域淋巴结均被切除。淋巴结清扫的平均时间为1小时40分钟，平均失血量为350毫升。术中并发症方面，3例发生血管损伤。其中1例左第二腰静脉受损。因此，在淋巴结清扫时应注意避免损伤该血管。术后观察到的并发症包括出血和乳糜腹水各1例。手术时必须仔细结扎淋巴管。6例发生淋巴结转移患者的5年生存率为33%。由此推测，淋巴结清扫有助于改善这些患者的预后。
