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作R2/3广泛淋巴结清扫的胃切除术对延长早期胃癌病人的存活时间具有重要的作用.在日本,这种病人的5年存活率目前已超过90%.然而,对于全部早期胃癌病人作这种广泛的淋巴结清扫的必要性还存在着争议.本文作者评价了R2/3胃切除术和R1胃切除术对无显微镜阳性淋巴结的早期胃癌病人手术后存活时间的影响.病人和方法:作者研究了1965~1987年间421例作淋巴结切除的胃切除术的早期胃癌病人的临床和组织学资料.病人的个均年龄为58.3岁(23~85岁),男女之比为2:1.将全部切除的胃和淋巴结作了显微镜检查,以确定癌的浸润深度,组织学类型,淋巴管和血管浸润,区域淋巴结转移.根据日本胃癌外科和病理研究协会的标准作病理诊断和分类.
Gastric resection for R2/3 extensive lymph node dissection has important effects on prolonging the survival time of patients with early-stage gastric cancer. In Japan, the 5-year survival rate of this patient has now exceeded 90%. However, for all patients with early gastric cancer, this is done. The need for a wide range of lymph node dissections remains controversial. The authors evaluated the effect of R2/3 gastrectomy and R1 gastrectomy on postoperative survival of early gastric cancer patients without positive lymph nodes. Patients and Methods: Authors’ studies The clinical and histological data of 421 early gastric cancer patients undergoing gastrectomy for lymph node dissection between 1965 and 1987. The average age of the patients was 58.3 years (23 to 85 years old), and the ratio between men and women was 2:1. The resected stomach and lymph nodes were examined by microscopy to determine the depth of invasion, histological type, lymphatic and vascular infiltration, and regional lymph node metastasis. The pathological diagnosis and classification were performed according to the Japanese Society of Gastric Surgery and Pathology Research Association.