| Gastric cancer is one of the most common malignancy. Its incidence rate was thethird in malignancy of our country, and23%malignant tumor deaths was due togastric cancer. Nowadays, total operation is only the method that could cure gastriccancer. The safety and thorough of operation depend upon a deep knowledge andunderstanding of anatomic structure around the gastric tumor.Laparoscopic operation, a minimally invasive surgical technique for20years,has applied into kinds of abdominal surgery recently. One proficient in laparoscopicoperation insisted that almost any open operation would be available to thelaparoscopic technique. Laparoscopic surgery for gastric cancer began in the early90’s of last century, and it has been highly developed recently. Laparoscopic radicaloperation of gastric cancer is a new technology which is based on not only theprinciple of following radical oncology but also minimally invasive. With thedevelopment of clinical experience and improvement of endoscopic techniques, it canbe used not only in early gastric cancer, but also for advanced gastric cancer resection.Laparoscopic operation would have replaced the traditional open operation in thefuture from the wide application and development trend of laparoscopic perspective.Laparoscopic radical gastrectomy for gastric cancer, compared with traditional openoperation, has the advantages of magnified vision, multi-angle, high brightness, highdefinition, less trauma and fast postoperative recovery and others. But the effect ofendoscopic operation will have difference due to the technical level and ability ofoperation, and there is no difference in survival benefit, which dased onevidence-based medicine in support of laparoscopic radical gastrectomy for gastriccancer. More distinctly understanding of anatomic can provide a new idea for theapplication development of laparoscopic, and promote the sprout and development ofanatomy in gross anatomy basis for endoscopic.How to effectively use the position of stomach lymph node in the microscopic,and defined the correct surgical plane through accurate microscopically anatomic location could not only make gastric cancer lymph node cleaning more security in thelaparoscopic surgery, but also keep the principle of oncology effect a radical cure,and finally achieve the best therapeutic effect. So it is that being familiar withstomach lymph node dissection of positioning is critical in laparoscopic gastric cancerradical surgery smoothly. In order to study the distribution characteristics of stomachlymph nodes, we positioned the lymph node of stomach by retrospecting laparoscopicgastric cancer radical surgery video and dissecting the autopsy. This would provideimportant guiding significance for a safe, thorough laparoscopic gastric cancer radicalprostatectomy.Objectives：By investigating the stomach lymph node distribution related to surgicalanatomy and laparoscopic positioning marks, in order that provide anatomical basisfor lymphadenectomy in laparoscopic surgery for gastric cancer.Methods：1.4specimens with10%formalin fixed were studied. Then we dissected thespecimens according to the steps of gastric cancer radical surgery surgical, observedand analyzed the distribution of lymph nodes.2. Clinical studies: The32cases of laparoscopic gastric radical gastrectomy fromOctober2010to toady in the third affiliated hospital of Nanchang University, werestudied and analyzed anatomic mark in lymphadenectomy.Results：These results shown stomach lymph nodes are located at the ligaments andmesangial surgical plane in both autopsy and surgical tape. Pancreas, arteria colicamedia, gastroduodenal artery, left gastric vessels, hepatopancreatic fold andgastropancreatic fold can be as the marker of lymphadenectomy.Conclusion：It would benefit to make gastric cancer surgery safe and radical when a surgeonis familiar with the lymph nodes location in laparoscopic and anatomic location,which may affect the safety and thoroughness of laparoscopic gastric cancer radicalsurgery and microscopically anatomic location logo application. |
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