Signficance and Surgical Skill for Lymphadenectomy of No.12a Lymph Node in Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZENG Yujian , LUO Huayou , TIAN Yan , SHU Ruo , CHENG Ruochuan

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China;

Corresponding author：

Keywords：

Gastric cancer; Operation; Lymphadenectomy

Video：

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Objective 　To investigate the significance and surgical skill for lymphadenectomy of No.12a lymph node around proper hepatic artery in gastric cancer.
Methods 　Among data of stageⅣ gastric cancer patients who received curative R0 gastrectomy, sixty-eight patients performed gastrectomy with D2 lymph node dissection, including No.12a lymph node were identified. Experiences and understanding of No.12a lymphadenectomy for gastric cancer were concluded.
Results 　The number of dissected No. 12a lymph node was 556 （5-11 per capita，mean 8.17 per capita） in 68 patients with stageⅣ gastric cancer, and the positive lymph node of No.12a was 33.27% （185/556）. There were no lymphadenectomy related complications： anastomotic leakage, lymphatic fistula， and postoperative hemorrhage in this series.
Conclusions 　Being familiar with the anatomy around proper hepatic artery and intrathecal liberation of proper hepatic artery, ligation of left gastric vein and right gastric artery at its onset, and exposure of gastroduodenal artery’s root and anterior wall of portal vein are important to dissection of No.12a lymph nodes.

Citation： ZENG Yujian,LUO Huayou,TIAN Yan,SHU Ruo,CHENG Ruochuan. Signficance and Surgical Skill for Lymphadenectomy of No.12a Lymph Node in Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(4): 416-418. doi: Copy

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1. 朱正纲. 应进一步提高胃癌综合治理的疗效 [J]. 中华胃肠外科杂志， 2007， 10(5)： 403-406.
2. Shin HR， Jung KW， Won YJ， et al. National cancer incidence for the year 2002 in Korea [J]. Cancer Res Treat， 2007， 39(4)：139-149.
3. 詹文华. 规范胃恶性肿瘤的外科治疗 [J]. 中国普通外科杂志，2000， 9(4)： 289-291.
4. Aurello P， D’Angelo F， Nigri G， et al. Comparison between site N-category and number N-category for nodal staging in carcinoma of the gastroesophageal junction：our experience and literature review [J]. Am Surg， 2006， 72(2)：118-123.
5. Karpeh MS， Leon L， Klimstra D， et al. Lymph node staging in gastric cancer：is location more important than number? An analysis of 1 038 patients [J]. Ann Surg， 2000， 232(3)：362-371.
6. Siewert JR， Böttcher K， Stein HJ， et al. Relevant prognostic factors in gastric cancer： ten-year results of the German Gastric Cancer Study [J]. Ann Surg， 1998， 228(4)：449-461.
7. Sobin LH， Hermanek P， Hutter RV. TNM classification of malignant tumors. A comparison between the new (1987) and the old editions[ J]. Cancer， 1998， 61(11)：2310-2314.
8. Oliver HB， Donald EH， Robert VP， et al. Manual for staging of cancer, American Joint Committee on cancer [M]. 4th ed. Philadelphia：JB Lippincott， 1992：53-56.
9. Fleming ID， Cooper JS， Henson DE， et al. Manual for staging of cancer, American Joint Committee on cancer [M]. 5th ed. New York： Springer， 1997：71-76.
10. Greene FL， Page DL， Fleming ID， et al. AJCC cancer staging manual， 6th ed [J]. Ann Oncol， 2003， 14(2)：345-346.
11. Sobin LH， Wittekind CH. UICC TNM classification of malignant tumors， 5th ed [J]. Cancer， 1997， 80(9)： 1803-1804.
12. Sobin LH， Wittekind CH. International Union Against Cancer (UICC)：TNM classification of malignant tumors， 6th ed [M].New York：Wiley， 2002：52-56.
13. Sayegh ME， Sano T， Dexter S， et al. TNM and Japanese staging systems for gastric cancer：how do they coexist? [J]. Gastric Cancer， 2004， 7(3)：140-148.
14. 日本胃癌學會. 胃癌處理規約 [M]. 14 版. 東京：金原出版，2010： 438.
15. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma： 3rd English edition [J]. Gastric Cancer，2011， 14(5)：101-112.
16. Wu CW， Hsiung CA， Lo SS， et al. Nodal dissection for patients with gastric cancer：a randomised controlled trial [J]. Lancet Oncol， 2006， 7(4)：309-315.
17. Sano T， Sasako M， Yamamoto S， et al. Gastric cancer surgery：morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy—Japan Clinical Oncology Group Study 9501 [J]. J Clin Oncol， 2004， 22(14)： 2767-2773.
18. Wu CW， Chang IS， Lo SS， et al. Complications following D3 gastrectomy：post hoc analysis of a randomized trial [J]. World J Surg， 2006， 30(1)： 12-16.
19. Wu CW， Chiou JM， Ko FS， et al. Quality of life after curative gastrectomy for gastric cancer in a randomised controlled trial [J]. Br J Cancer， 2008， 98(1)： 54-59.
20. Songun I， Putter H， Kranenbarg EM， et al. Surgical treatment of gastric cancer：15-year follow-up results of the randomised nationwide DUTCH D1 and D2 trial [J]. Lancet Oncol， 2010， 11(5)： 439-449.
21. Peng JJ， He YL， Zhan WH， et al. Vagina vasorum dissection during D2 lymphadenectomy for gastric carcinoma [J]. World J Gastroenterol， 2007， 13(12)：1867-1869.
22. 何裕隆. 胃癌淋巴转移 [M]. 北京：人民卫生出版社， 2011：17.
23. 彭建军，何裕隆，詹文华，等. 进展期胃癌对胃周围血管鞘的影响 [J]. 中国胃肠外科杂志， 2007， 10(1)： 49-52.
24. 韩方海，詹文华，何裕隆，等. 影响胃癌患者术后生存因素的Cox 分析 [J]. 中国普外基础与临床杂志， 2006， 13(1)： 29-35.
25. 韩方海，詹文华，何裕隆，等. 胃癌根治手术网膜囊及筋膜切除问题 [J]. 中国普外基础与临床杂志， 2007， 14(2)： 230-234.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Signficance and Surgical Skill for Lymphadenectomy of No.12a Lymph Node in Gastric Cancer

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