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我科从五十年代中期起,开展了扩大性切除术治疗胃癌,在边实践边总结,边吸取他人先进经验的基础上,有些观点几经修正。扩大性切除的手术范围为:切除近全胃或全胃(切端距肿瘤边缘5cm以上),在起始部结扎并切断脾动脉和胃左动脉,清除腹腔动脉旁、胃左动脉区、脾动脉区、肝动脉区(包括肝蒂及胰十二指肠后)的淋巴结,连同胰腺体尾部,大小网膜及横结肠系膜上层整块切除。1965年,我们根据24例胃癌扩大切除术标本的淋巴结研究,发现进行期病例的转移多不限于病灶邻近之胃岗淋巴结,而可同时波及远离原发病灶之胃周及深部淋巴结,即窦部癌肿可转移至贲门旁淋巴结。反
Since the mid-fifties, our department has carried out extensive resections to treat gastric cancer. While summarizing the practice, we have learned from the advanced experience of others, and some of our opinions have been corrected. The surgical range of the extended resection is: resection of the near or total stomach (cut end from the edge of the tumor more than 5cm), ligation at the beginning and cut off the splenic artery and left gastric artery, clear the celiac artery, left gastric artery area, splenic artery The lymph nodes in the area, hepatic artery area (including hepatic pedicle and posterior pancreatic duodenum), together with the pancreatic body tail, the entire size of the omentum and the transverse mesocolon membrane were removed. In 1965, we conducted a lymph node study of 24 specimens of patients with enlarged gastric cancer. We found that the metastases of patients undergoing progressive cases were not limited to the gastric lymph nodes adjacent to the lesions, but could also affect the periungral and deep lymph nodes distant from the primary lesions, ie, the sinuses. Cancer can be transferred to para-valvular lymph nodes. anti-