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虽然近十年手术技术有所改进,但与早期胃癌相比,晚期胃癌的手术效果不令人满意.然而作者对该院62年以来5000余例胃癌切除后的病例分析表明,各期淋巴结转移(TNM)五年生存率不断改善,以Ⅱ、Ⅲ期为著,分别从57%和33%增至83%和50%.其原因可能与更彻底的外科切除有关.即坚持应用根治性的切除附加系统性淋巴结清扫和切除全胃及邻近受累器官等.通过最初的广泛切除防止局部复发而不增加併发症率和死亡率,弥补常规淋巴结清扫后预后较差的不足.作者着重分析了1931例晚期胃癌切除伴广泛淋巴结清扫病人的淋巴结转移发生率与生存率,以明确这些发现是否会指导胃癌治疗中的淋巴结清扫.
Although surgical techniques have improved in the last decade, compared with early gastric cancer, the surgical effect of advanced gastric cancer is not satisfactory. However, the authors analyzed the cases after excision of more than 5,000 cases of gastric cancer in 62 years since the hospital, and showed that each stage of lymph node metastasis The five-year survival rate (TNM) continues to improve, with Phases II and III, increasing from 57% to 33% to 83% and 50%, respectively. The reason may be related to a more thorough surgical resection. Removal of additional systemic lymphadenectomy and resection of the entire stomach and adjacent affected organs, etc. Through the initial extensive resection to prevent local recurrence without increasing the complication rate and mortality, to make up for the poor prognosis after routine lymph node dissection. The author focuses on analysis The incidence and survival rate of lymph node metastasis in 1931 advanced gastric cancer patients with extensive lymphadenectomy were used to determine whether these findings would guide lymph node dissection during gastric cancer treatment.