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胃癌根治手术(R_2.R_3手术),已为许多外科医生所掌握,但关于各组淋巴结的准确范围及清除方法尚需进一探讨。胃癌的淋巴结清除常采用以下几种方法:一是随病变整块切除(en bloc),如胃周围的淋巴结(No.1、3、4、5、6、7),在切断血管的同时,将肉眼看不到的淋巴结一并清除。这是最理想的清除方法。二足单个摘除,对于解剖较复杂、部位较深、不能做联合脏器切除的淋巴结(No. 13. 12),可单个摘除。三是有些淋巴结与血管的关系很密切(No. 9、14、10、11、8a),在不断血管的情况下,将周围的神经纤维、脂肪组织及淋巴结一起清除,这是介于整块切除与单个摘除之间的一种清除方法。本文以幽门侧胃癌扩大根治术(R_3手术)为例,重
Gastric radical surgery (R_2.R_3 surgery) has been mastered by many surgeons, but the exact range and removal method of lymph nodes in each group still needs further investigation. Lymph node clearance of gastric cancer often uses the following methods: First, en bloc with the lesion (en bloc), such as the lymph nodes around the stomach (No. 1, 3, 4, 5, 6, 7), while cutting off blood vessels, We remove lymph nodes that are invisible to the naked eye. This is the best way to clear. A single removal of the two feet, for the more complex anatomy, deeper, can not be combined organ resection of lymph nodes (No. 13.12), can be a single removal. The third is that some lymph nodes are closely related to blood vessels (No. 9, 14, 10, 11, and 8a). In the case of continuous blood vessels, the surrounding nerve fibers, adipose tissue, and lymph nodes are eliminated together. A method of removal between removal and single removal. This article takes the pylorus gastric cancer extended radical surgery (R_3 surgery) as an example