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根据2010年日本《胃癌处理规约》推荐,对进展期胃上部癌行D2根治术时需清扫脾门淋巴结。近年来,随着腹腔镜技术和设备的不断发展,以及对脾脏功能的深入研究,腹腔镜胃癌根治术的保脾脾门淋巴结清扫受到越来越多的关注。但由于脾门区解剖复杂、转移淋巴结清扫困难,以及病人肥胖和脾门区粘连等原因,行腹腔镜保脾脾门淋巴结清扫时,出血常是外科医生需要面对的挑战。因此,掌握腹腔镜脾门淋巴结清扫出血的预防与处理的策略是顺利完成操作的保障。
According to the 2010 Japan’s “Gastric Cancer Treatment Protocol” recommendation, advanced radical gastric cancer in D2 radical surgery to clear splenic lymph nodes. In recent years, with the continuous development of laparoscopic techniques and equipment, as well as in-depth study of spleen function, laparoscopic radical gastrectomy of the spleen and spleen lymph nodes have received more and more attention. However, due to the spleen door anatomical complex, the difficulties of lymph node dissection, as well as patient obesity and splenomegaly adhesion and other reasons, laparoscopic splenectomy lymph node dissection, bleeding is often the surgeon need to face the challenge. Therefore, to master the prevention and treatment of laparoscopic splenic lymph node dissection bleeding strategy is to successfully complete the operation.