胃癌腹主动脉旁淋巴结清扫术(附26例临床分析)

The Clinical Analysis of Para-aortic Lymphdenection for 26 Cases with Gastric Carcinoma

目的:分析胃癌腹主动脉旁淋巴结(No.16)转移规律。方法:对本院2004年10月至2005年10月间实施的26例胃癌No.16淋巴结清扫术的临床病理资料作回顾性分析。结果:全组26例均行胃癌No.16(16a2区及16b1区)淋巴清扫术,术后恢复良好,无吻合口漏及手术死亡。乳糜腹1例,术中大出血1例。共切除No.16淋巴结79枚,平均3枚/例,发现肿瘤转移12枚,转移度为15.19%;4例患者发现No.16转移,转移率为15%。结论:No.16淋巴结作为胃癌区域淋巴液引流的终末汇聚地,有较高的转移率。不论是为了手术后正确分期还是提高治疗效果腹主动脉旁淋巴结清扫都是必要的,而且手术也是安全的。

Objective： To investigate the lymphatic metastasis of para-aortic lymph nodes （ No. 16 lymph nodes） in gastric carcinoma（AGC）. Methods： The clinical data of 26 patients with AGC undergone para-aortic lymph node dissection from Dec,2004 to Dec ,2005 were analysed retrospectively. Results： Among the 26 patients, 79 No. 16 lymph nodes were dissected, and 12 （ in 4 patients） had metastasis with a rate of 15.19% （12/79） and total metastasis rate was 15 % （4/26）. There was a case of lymphatic fistula and a case of mass bleeding and no operative death. Conclusions： Para-aortic lymph nodes are the end local collections for metastatic gastric carcinoma and with high metastasis rate. The para-aortic lymph nodes dissection is an essential operation in raising therapeutic effect and deciding post-operative grading for gastric carcinoma.