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贲门癌经腹淋巴结清扫的临床价值
引用本文:任明扬,张军,黄斌,邓思寒.贲门癌经腹淋巴结清扫的临床价值[J].西部医学,2009,21(11):1954-1956.
作者姓名:任明扬  张军  黄斌  邓思寒
作者单位:川北医学院第二嵇床医学院,南充市中心医院普外科,四川,南充,637000
摘    要:目的探讨贲门癌手术经腹淋巴结清扫的方法和意义。方法对63例进展期贲门癌患者行经腹D2+根治术治疗,并对淋巴结转移情况及术后生存时间进行分析。结果全组均完成D2+手术,全胃切除9例,近侧胃切除54例,其中联合脾切除3例,联合脾、胰尾切除2例,联合左肝外叶切除2例。术后病检均未发现切缘癌残留。淋巴结转移主要为1、2、3、7、8、9、11组淋巴结。术后1年生存率100%(51/51),2年生存率97.2%(35/36),3年生存率73.7%(14/19),4年生存率60%(3/5)。结论贲门癌淋巴结清扫的重点在腹腔,规范性淋巴结清扫是提高贲门癌术后生存时间的关键。对于侵犯食道<2cm的贲门癌经腹手术易于完成淋巴结彻底清扫。

关 键 词:贲门癌  淋巴结切除  经腹手术

Excise lymph node of gastric cardia cancer by transabdominai operation
Institution:REN Ming-yang,ZHANG Jun, HUANG Wing, et al (Department of General Surgery, The Central Hospital of Nanchong , Nanchong 637000, Sichuan , China)
Abstract:Objective To investigate the significance and method of lymph node excision by transabdominal approach in radical surgery of gastric cardia cancer. Methods Clinical data of 63 patients with gastric cardia cancer were reviewed. The information of lymph node metastasis, therapeutic efficacy and survival rate of D2+ radical surgery was analyzed. Results Of the 63 patients, 9 patients were treated with gastrectomy, 54 patients with proximum gastrectomy, 3 patients with spleneetomy, 3 patients with splenectomy and distal pancreatectomy and 2 patients with external lobe excision of left liver. There was no cancer cell to remain at cutting edge. The main lymph node metastasis was the 1st, 2nd , 3rd, 7th,8th, 9th and llth group Lymph node. 1-year survival rate was 100% (51/51). 3-year survival rate was 73. 7%(14/19)and 4-year survival rate was 60%(3/5). Conclusion Standard lymph node excision is the key to improve survival rate of gastric cardia cancer. It is easy and complete to excise lymph node by transabdominal approach in radical surgery of gastric cardia cancer that infiltrates esophagus fewer than 2 cm.
Keywords:Gastric cardia cancer  Lymph node excision  Transabdominal approach
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