CAJ | 학술논문

目的总结进展期胃癌D2根治术的经验,评价胃周血管脉络化淋巴结清扫的可行性及安全性.方法对24例进展期胃癌D2根治术及术后结果进行回顾性研究,总结胃癌D2根治术的手术经验.统计淋巴结清扫数目、手术失血量、术后并发症,评价手术可行性及安全性.结果 24例进展期胃癌患者D2根治术均取得成功,并获得R0切除.所有病例共清扫淋巴结634个,平均26.42个,淋巴结癌转移共206个,转移率为32.49％ (206/634).手术失血量平均为264.58 mL.术后并发症发病率为25％ (6/24),分别为:吻合口出血1例、食管空肠吻合之输入袢空肠端瘘1例、高淀粉酶血症2例、反流性食管炎2例.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,进展期胃癌D2根治术是安全可行的.
목적 총결진전기위암D2근치술적경험,평개위주혈관맥락화림파결청소적가행성급안전성.방법 대24례진전기위암D2근치술급술후결과진행회고성연구,총결위암D2근치술적수술경험.통계림파결청소수목、수술실혈량、술후병발증,평개수술가행성급안전성.결과 24례진전기위암환자D2근치술균취득성공,병획득R0절제.소유병례공청소림파결634개,평균26.42개,림파결암전이공206개,전이솔위32.49％ (206/634).수술실혈량평균위264.58 mL.술후병발증발병솔위25％ (6/24),분별위:문합구출혈1례、식관공장문합지수입번공장단루1례、고정분매혈증2례、반류성식관염2례.결론 재숙실위주국부해부,장악림파결청소기술,준순해부층차분리적기출상,진전기위암D2근치술시안전가행적.
Objective To summarize the experience of gastric D2 operation and evaluate the feasibility and safety of peripheral vascular choroid of lymph node dissection.Methods A retrospective study was adopted to analyze the redical D2 operation procedure and operation results 24 advanced gastric cancer cases,summarizing the experience of D2 radical gastrectomy operation for gastric cancer.The number of resected lymph nodes,operation bleeding volume,postoperative complications were analyzed to evaluate the feasibility and safety of operation.Results All 24 cases undergoing D2 radical gastrectomy operation of advanced gastric cancer were successful,and got the R0 resection.A total of 634 lymph nodes were excised in all the cases,averaged 26.42.A totle of 206 metastatic lymph nodes were found,metastasis rate being 32.49％.Operation bleeding volume was averaged 264.58 mL.The postoperative complication rate was 25％,anastomotic bleeding in 1 case,input loop jejunum fistula of esophageal jejunum anastomosis in 1 case,hyperamylasemia and 2 cases reflux esophagitis in 2 cases respectively.Conclusions D2 radical gastrectomy operation of gastric cancer is safe and feasible on the basis of mastering perigastric anatomy and master of lymph node excision technology and anatomical hierarchy separation.