保留脾脏的脾门淋巴结清扫在腹腔镜胃上部癌根治术中的临床研究——附7例报告

Clinical study of spleen-preserving splenic hilar lymph node dissection in laparoscopic radical gastrectomy for upper gastric cancer-Report of 7 cases

目的探讨腹腔镜脾门淋巴结清扫在胃上部癌根治术中的临床应用。方法选取我院在2018年3月-2019年2月就诊的共7例腹腔镜胃上部癌根治术中行保留脾脏的脾门淋巴结清扫的患者进行临床总结,观察临床效果。结果7例患者顺利完成手术,手术过程中未出现脾脏撕裂、中转切脾等不良反应。其中,术中出血量(89.23±22.34)ml,手术时间(3.76±0.45)h,术后住院时间(10.35±1.34)天。7例患者共检出20枚脾门淋巴结,1例患者检出1枚淋巴结,3例患者检出2枚淋巴结,1例患者检出3枚淋巴结,2例患者检出5枚淋巴结。术中清扫淋巴结总数均>15枚,阳性淋巴结构>2枚。结论腹腔镜脾门淋巴结清扫在上部胃癌根治术中安全可行,值得在临床上进一步推广应用。

Objective To explore the clinical application of laparoscopic splenic hilar lymph node dissection in radical operation of upper gastric cancer.Methods Seven cases of splenic hilar lymph node dissection during laparoscopic radical gastrectomy for upper gastric cancer in our hospital from March 2018 to February 2019 were selected for clinical summary and observation of clinical effect.Results Seven patients successfully completed the operation,and no adverse reactions such as splenic tear or transfer to splenectomy occurred during the operation.Among them,the amount of bleeding during operation was(89.23±22.34)ml,the operation time was(3.76±0.45)h,and the hospital stay was(10.35±1.34)days.A total of 20 splenic hilar lymph nodes were detected in 7 patients.One patient detected one lymph node,three patients detected two lymph nodes,one patient detected three lymph nodes,and two patients detected five lymph nodes.The total number of lymph nodes dissected during operation was>15,and the positive lymph nodes were>2.Conclusion Laparoscopic splenic hilar lymph node dissection is safe and feasible in radical gastrectomy for upper gastric cancer,which is worthy of further clinical application.