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1971年以来,我们对进行性胃癌均施行包括第一、二站淋巴结及部分第三站淋巴结在内的根治切除术,以探索提高胃癌远期疗效的合理手术方式。一、对清除肝十二指肠韧带内淋巴结((12)组)必要性的认识和对切除脾门淋巴结(⑩组)及脾动脉干淋巴结((11)组)的意见从解剖学上,胃远侧部为肝总动脉所属,肝十二指肠韧带包含着幽门上淋巴结(⑤组)和第(12)组淋巴结。幽门部和小弯部淋巴均引流入第(12)组淋巴结,(12)组与⑤组淋巴结的解剖关系十分密切。因此曾有人强调,在胃窦部癌时,第(12)组淋巴结虽属于第三站淋巴结,但应视为第二站来处理。有人在二次探查病例中发现第(12)组淋巴结继发癌的发生率很高。榊原等报道,胃窦部癌时,第(12)组淋巴结转移率为12～20%,与第二站淋巴结相似。国内也曾报告,无论原发癌位于贲
Since 1971, we have performed radical resection of advanced gastric cancer including lymph nodes in the first and second stations, and some third-station lymph nodes, in order to explore a reasonable surgical approach to improve the long-term efficacy of gastric cancer. I. Anatomically, the understanding of the need to remove lymph nodes within the hepatoduodenal ligament ((12) group) and the observation of resection of splenic lymph nodes (group 10) and lymph nodes of the splenic artery ((11) group) The distal part of the stomach belongs to the common hepatic artery, and the hepatoduodenal ligament contains lymph nodes on the pylorus (5 groups) and group (12). Lymph nodes in the pylorus and small bends flowed into the lymph nodes in group (12). The anatomical relationship between (12) group and five groups of lymph nodes was very close. Therefore, it has been emphasized that in the antrum cancer, the lymph node in group 12 belongs to the third station lymph node, but it should be treated as the second station. Some people in the second exploration case found a high incidence of secondary cancer in the (12) group of lymph nodes. Kasahara et al. reported that in the gastric antrum, the lymph node metastasis rate in the (12) group was 12 to 20%, similar to that in the second station lymph node. Domestically, it has also been reported whether primary cancer is located in