Adjacent,transversal and skipping metastases of sentinel lymph nodein middle third gastric cancer

[Objective] To investigate the distribution pathway of sentinel lymph nodes(SLN) in the middle third gastric carcinoma,as a foundation for rational lymphadenectomy.[Methods] We selected 52 middle third tumors with solitary lymph nodes from 1 852 gastric carcinomas.The location of metastatic lymph nodes,and the histological type were analyzed retrospectively.[Results] Of 52 solitary node metastases cases,37 were limited to perigastric nodes(N1),while 15 with skipping metastasis.In the 35 cases on the lesser curvature,17 were found in lymph nodes of the lesser curvature side(No.3),5 were involved in lymph nodes of the greater curvature(No.4),and 8 in lymph nodes of the left gastric artery(No.7).In 17 cases on the greater curvature,7 spread to No.4,while 3 metastasized to lymph nodes of the spleen hilum(No.10).The difference of the histological type in groups N1 and over N1,was not statistically significant(P0.05).[Conclusions] For patients with cancer in the middle area in the lesser curvature,No.7 should be dissected;for patients at the greater curvature,No.10 should be inspected more carefully;and if No.10 is questionable,a resection of spleen should be made.