摘要
在胃癌根治术中,规范清扫幽门下淋巴结(No.6)至关重要。基于幽门下区血管系统,幽门下淋巴结可分为胃网膜右静脉周围淋巴结(No.6v)、胃网膜右动脉周围淋巴结(No.6a)、幽门下动脉周围淋巴结(No.6i)3个亚组。在清扫操作中,术者须精准识别血管走行,以十二指肠、胰腺、结肠系膜等毗邻结构作为解剖标志,选择正确的解剖层面,依次离断血管分支并彻底清扫各组淋巴结,同时避免损伤毗邻器官。机器人手术系统、CT血管三维重建、荧光成像和纳米炭示踪导航等技术可提升淋巴结清扫的精准度与安全性。
In radical gastrectomy for gastric cancer,standardized dissection of the infrapyloric lymph nodes(No.6)is crucial.Based on the vascular system of infrapyloric region,the infrapyloric lymph nodes are systematically divided into three subgroups:No.6v(around the right gastroepiploic vein),No.6a(around the right gastroepiploic artery),and No.6i(around the infrapyloric arteries).During the dissection procedure,the surgeon must accurately identify the vascular course,using adjacent structures such as the duodenum,pancreas,and mesocolon as anatomical landmarks,and select the correct dissection plane within the mesenteric space.The vascular branches should be meticulously ligated in sequence,and each subgroup of lymph nodes should be thoroughly dissected while avoiding damage to adjacent organs.Advanced technologies including robotic surgical systems,CT-based 3D vascular reconstruction,fluorescence imaging,and nanocarbon tracing navigation,enhance the precision and safety of lymph node dissection.
作者
潘宏达
范昕
刘凤林
PAN Hong-da;FAN Xin;LIU Feng-lin(Department of Gastric SurgeryⅡ,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Gastric Surgery,Afiliated Hospital of Jiangsu University,Zhenjiang 212001,China)
出处
《中国实用外科杂志》
北大核心
2025年第7期784-787,共4页
Chinese Journal of Practical Surgery
基金
国家自然科学基金面上项目(No.82373381,No.82172803)。
关键词
胃癌
幽门下淋巴结
淋巴结清扫
腹腔镜手术
gastric cancer
infrapyloric lymph nodes
lymph node dissection
laparoscopic surgery
