胃癌第2站淋巴结清扫方法的研究

Procedures of D2 lymphadenectomy for patients with gastric cancer

目的总结胃癌第2站淋巴结清扫的手术体会。方法对57例胃癌D2淋巴结清扫手术方法及结果进行回顾性研究,统计淋巴结清扫数目、手术失血量、术后并发症,总结安全彻底的胃癌第2站淋巴结清扫经验及术中注意事项。结果 57例胃癌患者D2手术均取得成功,共清扫淋巴结1543枚,平均27.07枚;淋巴结癌转移共486枚,转移率31.5%。手术失血量平均244.7ml。术后并发症发生率22.8%,未出现淋巴结清扫相关的并发症。结论在熟悉胃周局部解剖,掌握淋巴结清扫技术,遵循解剖层次分离的基础上,是可以安全彻底地进行胃癌第2站淋巴结清扫的。

Objective To summarize the operative procedures of D2 lymphadenectomy for patients with gastric cancer. Methods 57 patients with gastric cancer who received D2 lymph node dissection were studied retrospectively. Their clinical data including the number of resected lymph nodes, intraoperative blood loss and postoperative complications were collected. Surgical skills for D2 lymph node dissection were summarized. Results All the 57 patients underwent successfully D2 lymph node dissection. In1543 lymph nodes harvested （mean 27.07）, 486 （31.5%） were metastatic lymph nodes. Blood loss was 244.7 ml on average and the postoperative complication rate was 22.8%. No lymph node dissection associated complication was found. Conclusion D2 lymph node dissection for patients with gastric cancer is effective if the surgeon is familiar with perigastric anatomy and lymph node excision skills.