论文部分内容阅读
目的 研究胃癌根治手术中肿大淋巴结实际转移状况并分析淋巴结切除范围与预后的关系。方法 查阅手术记录和术后病理报告并进行 5年随访。记录肿大淋巴结数 ,比较近端胃、远端胃和全胃切除术的淋巴结切除数目并分析其与预后的关系。结果 本组 15 5例胃癌标本中 ,共摘取淋巴结 3 3 0 5枚 (平均 2 1.3 2枚 /例 ) ;肿大淋巴结 10 3 7枚 (平均 6.69枚 /例 ) ;转移淋巴结 42 3枚 (平均 2 .73枚 /例 )。在 15 5例获 5年随访的患者中 ,行D2式手术 10 9例 ,D3式 46例 ,5年生存分别是 3 7例和 11例。结论 手术中肿大淋巴结不一定是转移淋巴结 ;胃癌根治术中淋巴结清扫范围不应盲目扩大 ,而应根据术中冰冻病检结果判断。
Objective To study the actual metastasis of lymph nodes in radical operation of gastric cancer and to analyze the relationship between the extent of lymph node resection and prognosis. Methods The surgical records and postoperative pathological reports were reviewed and followed up for 5 years. The number of enlarged lymph nodes was recorded. The number of lymph nodes resected in proximal stomach, distal stomach and total gastrectomy was compared and the relationship between prognosis and prognosis was analyzed. Results A total of 335 lymph nodes (an average of 2 1.3 2 cases / case) were collected from 15 5 gastric cancer specimens in this group. There were 107 cases of enlarged lymph nodes (average 6.69 cases / case), 42 cases of metastatic lymph nodes An average of 2.73 pieces / case). Among 15 5 patients who were followed up for 5 years, there were 109 patients undergoing D2 surgery and 46 patients undergoing D3 disease. The 5-year survival rates were 37 and 11, respectively. Conclusions The enlarged lymph nodes in operation are not necessarily metastatic lymph nodes. The range of lymph node dissection in radical operation of gastric cancer should not be blindly expanded, but should be judged according to the results of intraoperative frozen pathological examination.