Davydov M I, Germanov A B, Stilidi I S, Kuz'michev V A, Arzykulov Zh A
Khirurgiia (Mosk). 1995(5):41-6.
The authors describe 694 patients who underwent operation in 1985-1993 for carcinoma of the proximal part of the stomach with various degree of involvement of the adjacent parts of the stomach and esophagus. The tumors differed in histological structure. The main principles of classification of the groups of regional lymph nodes, taking into account the localization of the tumor in the stomach, are shown. These Principles are applied by Japanese surgeons in performing lymph node dissection and were modified in the Clinic od Thoracic Oncology of the Scientific Research Institute, Oncological Center, Russian Academy of medical Sciences. The localization and incidence of metastases in disseminated carcinoma of the proximal stomach with involvement of the esophagus were studied. The sequence of the stages of intraabdominal lymph node dissection in proximal gastric resection and gastrectomy is discussed. The tendency towards improvement on the indices of 3-year survival after expanded operations is noted. Expanded operations with scrupulous morphologic examination of the removed lymph nodes is very important for more precise determination of the stage and individual prognostication of the choice of the postoperative methods of treatment. In palliative interventions the operation is cytoreductive in essence and may create to a certain measure better conditions for chemotherapy.
作者描述了1985年至1993年间接受手术治疗的694例近端胃癌患者，这些患者的胃和食管相邻部位有不同程度的受累。肿瘤的组织结构各不相同。展示了根据肿瘤在胃中的定位对区域淋巴结分组进行分类的主要原则。这些原则被日本外科医生应用于淋巴结清扫术中，并在俄罗斯医学科学院肿瘤中心科研所胸科肿瘤诊所进行了修改。研究了伴有食管受累的近端胃癌播散性癌转移的定位和发生率。讨论了近端胃切除和胃切除术中腹腔内淋巴结清扫阶段的顺序。注意到扩大手术后3年生存率指标有改善的趋势。扩大手术并对切除的淋巴结进行细致的形态学检查对于更精确地确定分期和个体预后以及选择术后治疗方法非常重要。在姑息性干预中，手术本质上是减瘤性的，并且可以在一定程度上为化疗创造更好的条件。
