进展期胃癌腹主动脉旁淋巴结清扫术研究

A Study of Periaortic Lymph Nodes Dissection in Patients with Advanced Gastric Carcinoma

[目的]探讨进展期胃癌患者施行腹主动脉旁淋巴结（N16）清扫手术的必要性及手术适应证。[方法]通过对36例进展期胃癌患者行腹主动脉旁淋巴结（N16）清扫术,分析影响腹主动脉旁淋巴结转移的临床病理因素,并与同期进行的D2手术50例进行手术创伤程度、并发症及术后生活质量比较。[结果]腹主动脉旁淋巴结出现转移与肿瘤浸润深度、组织学类型及其他各组淋巴结转移有关。腹主动脉旁淋巴结（N16）清扫手术创伤程度比D2手术大,但主要并发症及术后生活质量与之并无明显差别。[结论]在T3、T4及低分化腺癌的进展期胃癌患者,腹主动脉旁淋巴结应纳入清扫范围之内。

[Purpose] To explore the necessity of periaortic lymph nodes dissection in patients with advanced gastric carcinoma, [Methods] Thirty-six cases with advanced gastric carcinoma underwent periaortic lymph nodes dissection, 50 cases with D2 surgery as controls. Surgical trauma, complications, quality of life were compared and clinical related factors with periaortic lymph nodes metastasis between 2 groups were compared. [Results] Periaortic lymph node metastasis was related with the depth of tumor infiltration, type of histopathology and other regional lymph nodes metastasis.Surgical trauma in patients with periaortic lymph nodes dissection was more serious than control(P < 0.05), but no ob-viouse difference was showed in the main complication and quality of life between the two groups. [Conclusion]Periaortic lymph nodes dissection should be performed in patients with T3 ,T4 tumor or low differential adenocarcinoma.