Analysis of No.12b Lymph Node Dissection for 60 Cases of Advanced Distal Gastric Cancer Accepting D2 Lymphadenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHUO Haibin , ZHUO Sufang.

Department of General Surgery, The People’s Hospital of Cili County, Zhangjiajie 427200，Hunan Province, China;

Corresponding author：

Keywords：

Gastric cancer; Distal gastric cancer; Choledochus lymph node; Lymphadenectomy; Lymph node metastasis

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Objective To study the necessity and feasibility of No.12b lymph node dissection in D2 lymphadenectomy for advanced distal gastric cancer, and the relation between No.12b lymph node metastasis and clinicopathologic factors.
Methods Clinical data of sixty cases of advanced distal gastric cancer receiving D2 or D2+ radical correction were collected retrospectively, both of which were all plus No.12b lymph node dissections. The relationships between No.12b lymph node metastasis and clinicopathologic factors were analyzed.
Results No death attributed to operation or severe operative complications were found. There were 12 cases (20.00%) with No.12b lymph node metastasis. The rates of No.12b lymph node metastasis in Borrmann Ⅲ-Ⅳ types, N2-3 of lymph node metastasis and T3-4 of tumor infiltration were 31.25% (10/32), 30.30% (10/33) and 29.73% (11/37), which were significantly higher than those in Borrmann Ⅰ-Ⅱ types 〔7.14% （2/28）〕, N0-1 〔7.41% （2/27）〕 and T1-2 〔4.35% （1/23）〕 respectively (P lt;0.05). There was no relationship between tumor size and No.12b lymph node metastasis.
Conclusions No.12b lymph node dissection is safe and feasible for advanced distal gastric cancer. Further perspective studies on No.12b lymph node dissection influence on prognosis in more cases are required.

Citation： ZHUO Haibin,ZHUO Sufang.. Analysis of No.12b Lymph Node Dissection for 60 Cases of Advanced Distal Gastric Cancer Accepting D2 Lymphadenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(5): 474-477. doi: Copy

1.	孙秀娣, 牧人, 周有尚, 等. 中国胃癌死亡率20年变化情况分析及其发展趋势预测 [J]. 中华肿瘤杂志, 2004; 26(1): 4-9.
2.	尹浩然, 朱正纲, 林言箴. 进展期胃癌外科综合治疗的方法与步骤 [J]. 外科理论与实践, 2000; 5(3): 134-135.
3.	Spanknebel KA, Brennan MF. Is D2 lymphadenectomy for gastric cancer a staging tool or a therapeutic intervention? [J]. Surg Oncol Clin N Am, 2002; 11(2): 415-430.
4.	李锋. 进展期胃癌D2、D3术式的临床研究 [J]. 广西医学, 2002; 24(7): 1026-1028.
5.	陈波, 刘文治, 王舒宝. 胃癌新TNM 分期与GRGCS分期的比较与评价 [J]. 中国医科大学学报, 1999; 28(5): 395-396.
6.	Shimada Y. JGCA (The Japan Gastric Cancer Association). Gastric cancer treatment guidelines [J]. Jpn J Clin Oncol, 2004; 34(1): 58.
7.	詹文华, 何裕隆, 郑章清, 等. 进展期胃癌行腹主动脉旁淋巴结清扫的疗效观察 [J]. 中华外科杂志, 2003; 41(5): 375-378.
8.	Baba M, Hokita S, Natsugoe S, et al. Paraaortic lymphadenectomy in patients with advanced carcinoma of the upper-third of the stomach [J]. Hepatogastroenterology, 2000; 47(33): 893-896.
9.	姜波健, 吴巨钢, 俞继卫, 等. 胃癌淋巴管生成、淋巴管浸润及淋巴结微转移的临床意义 [J]. 中国普外基础与临床杂志, 2008; 15(12): 903-909.
10.	毛志坚, 唐茂枫. 进展期胃癌近段行D2～D3手术体会 [J]. 中国医药杂志, 2004; 1(2): 103-105.
11.	陈筱民, 张善忠. 进展期胃癌D3根治术的临床观察 [J]. 中华临床医学研究杂志, 2007; 13(11): 1469-1470.
12.	詹文华. 淋巴结清扫手术治疗胃癌的现状 [J]. 中国实用外科杂志, 1999; 19(2): 120-121.
13.	何裕隆. 进展期胃癌淋巴结清扫合理范围 [J]. 实用医学杂志, 2007; 23(18): 2803-2804.
14.	Roukos DH, Kappas AM. Perspectives in the treatment of gastric cancer [J]. Nat Clin Pract Oncol, 2005; 2(2): 98-107.
15.	覃新干, 林进令, 黄源, 等. 进展期远端胃癌淋巴结转移特点与D2术式的应用 [J]. 临床和实验医学杂志, 2008; 7(10): 25-26.
16.	鱼海峰, 王道荣. 腹腔镜辅助下胃癌D2根治术应用现状 [J]. 中国现代普通外科进展, 2009; 12(6): 514-516.
17.	韩方海, 张肇达. 胃癌淋巴结清扫范围的探讨 [J]. 实用肿瘤杂志, 2008; 23(2): 97-100.
18.	潘忠清, 姜涛, 夏有恒. 我国胃癌外科治疗演变的概况 [J]. 中国现代普通外科进展, 2008; 11(6): 511-513, 533.
19.	袁晓东. 进展期胃远侧癌的淋巴结转移和手术治疗 [J]. 东南大学学报(医学版), 2001; 20(4): 269-270.
20.	陈志新, 胡建昆, 于永扬, 等. 近、远端胃癌临床病理特点分析(附428例报告) [J]. 中国普外基础与临床杂志, 2002; 9(3): 151-153.
21.	Nakajima T. Gastric cancer treatment guidelines in Japan [J]． Gastric Cancer, 2002; 5(1): 1-5.
22.	Maruyama K, Okabayashi K, Kinoshita T. Progress in gastric cancer surgery in Japan and its limits of radicality [J]. World J Surg, 1987; 11(4): 418-425.
23.	Moriwaki Y, Kobayashi S, Kunisaki C, et al. Is D2 lymphadenectomy in gastrectomy safe with regard to the skill of the operator? [J]. Dig Surg, 2001; 18(2): 111-117.
24.	Nitti D, Marchet A, Olivieri M, et al. Lymphadenectomy in patients with gastric cancer. A critical review [J]． Suppl Tumori, 2003; 2(5): S35-S38.
25.	张伟, 庞明辉, 罗斌, 等. 腹腔镜远端胃癌根治术18例报道 [J]. 中国普外基础与临床杂志, 2009; 16(10): 785-788.

1. 孙秀娣, 牧人, 周有尚, 等. 中国胃癌死亡率20年变化情况分析及其发展趋势预测 [J]. 中华肿瘤杂志, 2004; 26(1): 4-9.
2. 尹浩然, 朱正纲, 林言箴. 进展期胃癌外科综合治疗的方法与步骤 [J]. 外科理论与实践, 2000; 5(3): 134-135.
3. Spanknebel KA, Brennan MF. Is D2 lymphadenectomy for gastric cancer a staging tool or a therapeutic intervention? [J]. Surg Oncol Clin N Am, 2002; 11(2): 415-430.
4. 李锋. 进展期胃癌D2、D3术式的临床研究 [J]. 广西医学, 2002; 24(7): 1026-1028.
5. 陈波, 刘文治, 王舒宝. 胃癌新TNM 分期与GRGCS分期的比较与评价 [J]. 中国医科大学学报, 1999; 28(5): 395-396.
6. Shimada Y. JGCA (The Japan Gastric Cancer Association). Gastric cancer treatment guidelines [J]. Jpn J Clin Oncol, 2004; 34(1): 58.
7. 詹文华, 何裕隆, 郑章清, 等. 进展期胃癌行腹主动脉旁淋巴结清扫的疗效观察 [J]. 中华外科杂志, 2003; 41(5): 375-378.
8. Baba M, Hokita S, Natsugoe S, et al. Paraaortic lymphadenectomy in patients with advanced carcinoma of the upper-third of the stomach [J]. Hepatogastroenterology, 2000; 47(33): 893-896.
9. 姜波健, 吴巨钢, 俞继卫, 等. 胃癌淋巴管生成、淋巴管浸润及淋巴结微转移的临床意义 [J]. 中国普外基础与临床杂志, 2008; 15(12): 903-909.
10. 毛志坚, 唐茂枫. 进展期胃癌近段行D2～D3手术体会 [J]. 中国医药杂志, 2004; 1(2): 103-105.
11. 陈筱民, 张善忠. 进展期胃癌D3根治术的临床观察 [J]. 中华临床医学研究杂志, 2007; 13(11): 1469-1470.
12. 詹文华. 淋巴结清扫手术治疗胃癌的现状 [J]. 中国实用外科杂志, 1999; 19(2): 120-121.
13. 何裕隆. 进展期胃癌淋巴结清扫合理范围 [J]. 实用医学杂志, 2007; 23(18): 2803-2804.
14. Roukos DH, Kappas AM. Perspectives in the treatment of gastric cancer [J]. Nat Clin Pract Oncol, 2005; 2(2): 98-107.
15. 覃新干, 林进令, 黄源, 等. 进展期远端胃癌淋巴结转移特点与D2术式的应用 [J]. 临床和实验医学杂志, 2008; 7(10): 25-26.
16. 鱼海峰, 王道荣. 腹腔镜辅助下胃癌D2根治术应用现状 [J]. 中国现代普通外科进展, 2009; 12(6): 514-516.
17. 韩方海, 张肇达. 胃癌淋巴结清扫范围的探讨 [J]. 实用肿瘤杂志, 2008; 23(2): 97-100.
18. 潘忠清, 姜涛, 夏有恒. 我国胃癌外科治疗演变的概况 [J]. 中国现代普通外科进展, 2008; 11(6): 511-513, 533.
19. 袁晓东. 进展期胃远侧癌的淋巴结转移和手术治疗 [J]. 东南大学学报(医学版), 2001; 20(4): 269-270.
20. 陈志新, 胡建昆, 于永扬, 等. 近、远端胃癌临床病理特点分析(附428例报告) [J]. 中国普外基础与临床杂志, 2002; 9(3): 151-153.
21. Nakajima T. Gastric cancer treatment guidelines in Japan [J]． Gastric Cancer, 2002; 5(1): 1-5.
22. Maruyama K, Okabayashi K, Kinoshita T. Progress in gastric cancer surgery in Japan and its limits of radicality [J]. World J Surg, 1987; 11(4): 418-425.
23. Moriwaki Y, Kobayashi S, Kunisaki C, et al. Is D2 lymphadenectomy in gastrectomy safe with regard to the skill of the operator? [J]. Dig Surg, 2001; 18(2): 111-117.
24. Nitti D, Marchet A, Olivieri M, et al. Lymphadenectomy in patients with gastric cancer. A critical review [J]． Suppl Tumori, 2003; 2(5): S35-S38.
25. 张伟, 庞明辉, 罗斌, 等. 腹腔镜远端胃癌根治术18例报道 [J]. 中国普外基础与临床杂志, 2009; 16(10): 785-788.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of No.12b Lymph Node Dissection for 60 Cases of Advanced Distal Gastric Cancer Accepting D2 Lymphadenectomy

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