PROXIMAL SUBTOTAL GASTRECTOMY FOR THE TREATMENT OF CARCINOMA OF THE UPPER 3RD OF THE STOMACH - ITS INDICATIONS BASED ON LYMPH-NODE METASTASIS AND PERIGASTRIC LYMPHATIC FLOW

被引:17
作者
ISOZAKI, H
OKAJIMA, K
YAMADA, S
NAKATA, E
NISHIMURA, J
ICHINONA, T
TANIMURA, M
TAKEDA, Y
机构
[1] The Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, 569, 2-7 Daigaku-machi, Takatsuki
来源
SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY | 1995年 / 25卷 / 01期
关键词
PROXIMAL SUBTOTAL GASTRECTOMY; GASTRIC CANCER; LYMPH NODE METASTASIS; PERIGASTRIC LYMPHATIC FLOW;
D O I
10.1007/BF00309380
中图分类号
R61 [外科手术学];
学科分类号
摘要
To clarify the indications for a proximal subtotal gastrectomy in the treatment of carcinoma in the upper third of the stomach based on lymph node metastases, 1055 patients in whom either a D-2 or greater lymph node removal was performed were reviewed. In the patients in which the lesion was confined to the upper stomach and did not invade beyond the muscularis propria of the stomach wall, no metastases to either the lymph nodes above and below the pylorus or the lymph nodes along the greater curvature were observed. A lymphatic flow study revealed a minimal flow to these nodes from the upper stomach in patients without lymph node metastasis, but in cases with lymph node metastases the lymphatic flow changed. The indications for a proximal subtotal gastrectomy for a carcinoma of upper third of the stomach therefore must fulfill the following two conditions: (1) The deepest layer of cancerous invasion does not extend beyond the muscularis propria of the stomach wall, and (2) No macroscopic evidence of lymph node metastasis can be detected during surgery.
引用
收藏
页码:21 / 26
页数:6
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