胃淋巴系より観たる膵尾側合併切除術成立の根拠について

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概要

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• A pathological study was carried out for clinical evaluation of gastrectomy combined with resection of the tail of the pancreas and the spleen for a radical cure in cancer of the stomach. This statistical survey covers 1) an investigation in cancerous invation of the adjacent organs with 367 cases suffering from gastric cancer and 29 removed specimens, and 2) a systematic observation of lymphatic drainage of the stomach, both normal and cancerous cases, by means of pontamine sky blue during operation and histological study of 20 removed specimens. In this connection, operative and followup results were also evaluated. What follow are results of thesestudies: 1) Infiltrative adhesion to the tail of the pancreas is the most frequent event in cancer of the cardia or the body of the stomach. In this situation, combined resection of the tail of the pancreas must of necessity be executed. 2) In the posterior wall of the normal stomach, especially in the cardiac segment, close communications were 'confirmed not only with regional lymph nodes but also with retroperitoneal lymphatic system in the vicinity of the pancreas and the spleen. On the other hand, retrograde lymphatic drainage. is the common event in cancer of the stomach, which enforces us the enlargement of resection of malignant areas for a radical cure. This is especially true in the case of cardiac cancer in which much closer connection with retroperitoneal lymph nodes is found. It is quite obvious that the complete removal of lymph nodes involved is attainable only by en masse resection of these two adjacent organs. 3) On the other hand, operative mortality rate and follow-up results of our patients undergoing surgical treatment for cancer of the stomach indicated a definite superiority of this combined resection over the gastrectomy itself. These points mentioned above offer us unequivocal grounds of the necessity of this operative procedure for radical cure in more or less advanced cancer of the stomach.

• 千葉大学の論文
• 1955-09-28

著者

• 木村 滋

  千葉大学医学部

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