DISSECTION OF LYMPH NODES IN THE HEPATODUODENAL LIGAMENT IN THE D2+ RESECTION FOR GASTRIC CANCER

Background:It has been debated whether an extended lymph node dissection for gastric cancer is beneficial.Theoretically, removal of a wider range of lymph nodes by extended lymph node dissection increases the chance for cure.Lymph nodes in the hepatoduodenal ligament are important for stage. Method:105 cases with gastric cancer were operated from 01/2003 to 12/2005 with total gastrectomy and extended D2 lymphadenectomy,including dissection of lymph nodes in the hepatoduodenal ligament. Among all cases 8 were in stageⅠ,22 in stageⅡ,48 in stageⅢand 27 in stageⅣaccording to the TPM staging. Results:The involvement rate in lymph nodes along the proper hepatic artery was 16.2%and that in lymph nodes along the common bile duct was 7.61 The post operative death was 2.01 53 cases were able to be followed up for more than one year or died within one year.The one year survival rate was 88.7% (47/53). Conclusions:The metastases rates of lymph nodes in the hepatoduodenal ligament were related to primary tumor,size,regional lymph nodes involved and stage of the tumors. Cases of gastric cancer with metastases of lymph nodes in the hepatoduodenal ligament had poor prognosis.