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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 549 -551. doi: 10.3877/cma.j.issn.1674-3946.2020.06.003

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3D腹腔镜近端胃癌根治脾门淋巴结清扫优势
胡建昆1,(), 陈小龙1   
  1. 1. 610041,成都 四川大学华西医院胃肠外科中心/胃癌研究室
  • 收稿日期:2020-02-06 出版日期:2020-12-26
  • 通信作者: 胡建昆

Advantages of three-dimensional laparoscopy in splenic hilar lymphadenectomy in radical gastrectomy for proximal gastric cancer

Jiankun Hu1,(), Xiaolong Chen1   

  1. 1. Department of Gastrointestinal Surgery and Laboratory of Gastric Cancer, West China Hospital, Sichuan University
  • Received:2020-02-06 Published:2020-12-26
  • Corresponding author: Jiankun Hu
  • About author:
    Corresponding author: Hu Jiankun, Email:
  • Supported by:
    1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University(ZY2017304); National Natural Science Foundation of China(81702366); Sichuan Science and Technology Program(2019YFS0255); Ten Thousand Talent Program of Sichuan Province(No.101)
引用本文:

胡建昆, 陈小龙. 3D腹腔镜近端胃癌根治脾门淋巴结清扫优势[J/OL]. 中华普外科手术学杂志(电子版), 2020, 14(06): 549-551.

Jiankun Hu, Xiaolong Chen. Advantages of three-dimensional laparoscopy in splenic hilar lymphadenectomy in radical gastrectomy for proximal gastric cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(06): 549-551.

近端胃癌的发病率呈上升趋势。对于位于胃中上部、大弯侧、直径6 cm以上的T3~4分期胃癌,我国胃癌诊治规范(2018年版)建议行D2+脾门淋巴结清扫。脾门淋巴结位置深在,与脾门众多血管关系紧密,清扫难度较大,可能损伤脾门血管。与传统腹腔镜相比,3D腹腔镜可为外科医生提供更好的三维立体视野和纵深感。清扫脾门淋巴结时,3D腹腔镜在判断脾门淋巴结解剖层次和辨认血管走行方面具有更大的优势,有利于外科医生更安全和彻底地清扫脾门淋巴结。

The incidence of proximal gastric cancer tends to be increasing. D2+ splenic hilar lymphadenectomy is suggested by Chinese guidelines for diagnosis and treatment of gastric cancer(2018 version) for primary T3~4 tumors with 6 cm or larger in diameter that is located in the greater curvature and upper-middle stomach.Splenic hilar lymph nodes are located deep and closely adjacent with many vessels around splenic hilum. For surgeons, it is difficult to dissect splenic hilar lymph nodes and it is possible to injure vessels around splenic hilum. Compared with traditional laparoscopy, 3D laparoscopy can provide better tridimensional vision and feeling of depth. 3D laparoscopy is superior in distinguishing anatomic plane of splenic hilar lymph nodes and recognizing vessels, which is helpful for surgeons to dissect splenic hilar lymph nodes more safely and completely.

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