保脾脾门淋巴清扫在进展期近端胃癌根治术中的应用

Application of spleen-preserving splenic hilar lymph nodes dissection in radical resection for advanced proximal gastric cancer

目的探讨保留脾脏的脾门淋巴清扫在近端胃癌根治术中应用的可行性。方法选取我院2012年5月至2013年5月收治的确诊为进展期近端胃癌的6例患者资料，采取保脾脾门淋巴清扫的D2淋巴结清扫术，记录手术时间、出血量、脾门淋巴结数目，观察术后并发症情况。结果6例手术均成功完成，术中出血量50～250mL，平均120mL；术后脾门淋巴结清扫数目3～9个，平均5个。术后有1例出现淋巴漏并发症，经治疗后均痊愈出院；随访1个月至1年，无局部复发及远处转移病例，无死亡病例。结论在进展期近端胃癌D2淋巴结清扫术中保留脾脏同时可以安全彻底地清除脾门淋巴结。

Objective To investigate the feasibility of spleen-preserving splenic hilar lymph nodes dissection on the radical resection for advanced proximal gastric cancer. Methods Six patients with advanced proximal gastric cancer were performed D2 lymphadenectomy from May 2012 to May 2013 in our hospital. The operation time, bleeding quantity, the number of lymph nodes, postoperative complications were re- corded. Results The surgery was successful. The intraoperative blood loss was 50 - 250 mL, with the average of 120 mL. The number of lymph nodes was 3 ~ 9 after the operation with the average of 5. One patient supervened with lymphorrhagia and recovered after treatment. During the follow-up period from one month to one year, no local recurrence and distant metastasis occurred, nor the death. Conclusion Conducting theD2 lymphadenectomy for the patients with the advanced proximal gastric cancer can preserve the spleen while safely and throughly dissect the splenic hilar lymph nodes.