Nashimoto A, Sasaki J, Sano M, Tanaka O, Tsutsui M, Tsuchiya Y, Makino H
Division of Surgery, Niigata Cancer Center Hospital, Japan.
Surg Today. 1997;27(2):169-73. doi: 10.1007/BF02385910.
We herein report the case of a 63-year-old woman who underwent curative surgery consisting of a subtotal gastrectomy with D2 lymph node dissection for advanced stomach cancer in June 1984, and later underwent systemic dissection of recurrent abdominal paraaortic lymph nodes by a retromesenteric approach in June 1989. Metastatic nodes were found in nos. 16b1 (interaorticocaval), 16b2 (interaorticocaval), and 280 (aortic carinal). One of the resected nodes, which was histologically diagnosed as being poorly differentiated adenocarcinoma, measured approximately 10 x 7 cm and infiltrated the inferior caval vein. There was no distant metastasis except for nodal metastases. Since the reoperation, the patient has been disease-free for 6 years and 4 months, and she continues to visit our hospital as an outpatient. The findings of this case therefore suggest the significance of paraaortic lymph node dissection. To our knowledge, this is the first report in the world of a gastric cancer patient who has remained disease-free for more than 5 years after the systemic dissection of recurrent paraaortic lymph nodes.
我们在此报告一例63岁女性患者的病例。该患者于1984年6月接受了根治性手术，包括对进展期胃癌行D2淋巴结清扫的胃次全切除术，随后于1989年6月通过肠系膜后入路对复发性腹主动脉旁淋巴结进行了系统性清扫。在16b1（主动脉腔静脉间）、16b2（主动脉腔静脉间）和280（主动脉隆突下）发现了转移淋巴结。其中一个切除的淋巴结经组织学诊断为低分化腺癌，大小约为10×7 cm，并侵犯了下腔静脉。除淋巴结转移外，无远处转移。自再次手术后，患者已无病生存6年4个月，目前仍作为门诊患者定期来我院就诊。因此，该病例的结果提示了主动脉旁淋巴结清扫的重要性。据我们所知，这是世界上首例复发性主动脉旁淋巴结系统性清扫术后无病生存超过5年的胃癌患者的报告。
