胃上部癌手术保留脾胰清除No.10、11淋巴结的可行性探讨

Study of splenopancreatic-preserving dissection of No.10 and No.11 lymphatic nodes in radical resection for proximal gastric carcinoma

目的探讨胃上部癌手术保留脾脏、胰腺,清除No.10、11淋巴结的可行性。方法回顾性分析采用保留脾脏、胰腺治疗62例胃上部癌患者的手术情况。结果本组62例患者中50例有淋巴结转移(80.6%),No.10转移率为19.4%(12/62),No.11转移率为22.6%(14/62);每组清扫淋巴结数为3～8枚。术后并发症发生率为16.1%。无死亡病例。结论保留脾脏、胰腺,清除No.10、11淋巴结手术操作可行,是胃上部癌一种安全可行的手术方法。

Objective To investigate the feasibility of splenopancreatic-preserving dissection of No. 10 and No. 11 lymph nodes in radical resection for proximal gastric carcinoma. Methods The data of 62 patients with proximal gastric carcinoma undergoing splenopancreatic-preserving dissection of No. 10 and No. 11 lymph nodes were analyzed retrospectively. Results This splenopancreatic-preserving dissection was effective significantly. The incidences of lymphatic metastasis in No. 10 and No. 11 were 19. 4% and 22. 6% respectively, and the incidence of complications was 16. 1%, significantly lower than that（40% ） of non-splenopancreatic-preserving dissection. Conclusions The splenopancreatic-preserving dissection of No. 10 and No. 11 lymph nodes is a safe and feasible method in radical gastrectomy for proximal gastric carcinoma. The surgical procedure is not difficult. With careful operation, the complete clearance of the lymph nodes can be obtained.