| Objective:To investigate the feasibility and necessity of N0.13LN dissection for advanced gastric carcinoma.Methods:The clinical data of 133 cases who were diagnosed as advanced gastric carcinoma were collected from January 2007 to June 2009 in Department of General Surgery, First Affiliated Hospital of Nanchang University.67 cases who were received D2 Radical gastrectomy plus NO.13LN dissection as the study group; 66 cases who were received D2 Radical gastrectomy as the control group, comparing the difference in the perioperative period and postoperative survival time; then analyzing the relationship of the local recurrence, metastasis, prognosis and the clinicopathological factors of positive NO.13LN.Results:1. Statistics show no significant difference in operation time, blood loss, surgical complications, hospital stay and 1 year survival; the study group was significantly better than the control group in the postoperative survival time.2. Postoperative adjuvant chemotherapy on survival time of study group and control group were improved, there are significant differences.3.17 cases of positive NO.13LN were found in the study group. The positive rate is 25.4%; which were related with primary tumor position, tumor diameter, depth of invasion, station of lymph node, TNM stage and whether the infringement of vascular; may related with histological type; nothing with Borrmann type; multivariate analysed:tumor invasion and lymph node metastasis N stage leading to an independent risk factor of NO.13LN; survival curve analysis showed:significantly different on survival time of NO.13LN positive group was lower than NO.13LN negative group.4. NO.13LN positive cases of advanced gastric cancer with high recurrence, high metastasis and poor prognosis; while NO.13LN positive cases may reap the benefits from postoperative adjuvant chemotherapy. Conclusion:NO.13LN dissection for advanced gastric cancer is feasible and necessary. |
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