Objective To investigate the significance and surgical skill for lymphadenectomy around common hepatic artery in gastric cancer. Methods Two hundred and fifty-seven cases with undergoing lymphadenectomy around common hepatic artery in gastric cancer between January 2001 and December 2006 were retrospectively reviewed. Experiences and understanding of dealing with this procedure in curative gastrectomy for gastric cancer were concluded. Results The number of dissected No.8 lymph node was 2.2±1.7, and the positive rate of No.8 lymph node was 30.35%. There were no lymphadenectomy related complications, such as anastomotic leakage, lymphatic fistula and postoperative hemorrhage in this series. Dissection around common hepatic artery lymph nodes along artery intrathecal space, division and ligation of left gastric vein at its root, and sufficient exposure of anatomic structures were important to dissection lymph nodes around the common hepatic artery. The exposure of anatomic structures included liberation of common hepatic artery by traction with the band, and the exposure of posterior side of pancreas by Kocher incision.Conclusion Being familiar with the anatomy around common hepatic artery, careful dissection, and attention to the surgical skill of lymphadenectomy are very important to improve the effectiveness of lymphadenectomy around common hepatic artery in gastric cancer.
目的 探讨消化道类癌的诊断和治疗。方法 对我院1992年10月至2002年12月收治的23例消化道类癌患者的临床资料进行回顾性分析。结果 23例消化道类癌中3例胃类癌，1例十二指肠类癌，4例阑尾类癌，3例结肠类癌，12例直肠类癌。术前9例（39%）经活检确诊； 术后经病检23例中11例（47.8%）浸润程度超过肌层； 4例（17.4%）有区域淋巴结转移； 8例经神经元特异性烯醇酶（NSE）检查（此酶为神经内分泌肿瘤的重要标志物，具有诊断价值）有6例阳性表达，表达阳性率为75%。结论 病变部位、浸润深度、淋巴结转移是决定消化道类癌预后的关键因素，手术是有效的治疗方式。