Abstract:

Prevention and treatment of bleeding for laparoscopic spleen-preserving splenic hilus lymphadenectomy for gastric cancer        HUANG Chang-ming，CHEN Qi-yue. Department of Gastric Surgery，Fujian Medical University Union Hospital，Fuzhou 350001，China
Corresponding author：HUANG Chang-ming，E-mail：hcmlr2002@163.com
Abstract    Splenic hilar lymph node (LN) should be removed in a D2 lymph node dissection for the advanced proximal gastric cancer，according to Japanese Gastric Cancer Treatment Guidelines 2010. In recent years，with the continuous development and improvement of laparoscopic anatomy technology and equipment，and the in-depth study of spleen function，laparoscopic spleen-preserving splenic hilus lymphadenectomy has received more and more attention and been gradually being used in operations. However，because of the complexity of splenic hilar anatomy，the challenges of metastatic lymph node dissection，obesity，adhesions of the splenic hilus，etc. bleeding is often a challenge for surgeons in laparoscopic spleen-preserving splenic hilus lymphadenectomy. Therefore，mastering the strategies of prevention and treatment of bleeding for laparoscopic spleen-preserving splenic hilar LN dissection is critical for successfully completing the operation.

Key words: gastric cancer, laparoscopy, splenic hilus lymphadenectomy, bleeding

摘要：

根据2010年日本《胃癌处理规约》推荐，对进展期胃上部癌行D2根治术时需清扫脾门淋巴结。近年来，随着腹腔镜技术和设备的不断发展，以及对脾脏功能的深入研究，腹腔镜胃癌根治术的保脾脾门淋巴结清扫受到越来越多的关注。但由于脾门区解剖复杂、转移淋巴结清扫困难，以及病人肥胖和脾门区粘连等原因，行腹腔镜保脾脾门淋巴结清扫时，出血常是外科医生需要面对的挑战。因此，掌握腹腔镜脾门淋巴结清扫出血的预防与处理的策略是顺利完成操作的保障。

关键词: 胃癌, 腹腔镜, 脾门淋巴结清扫, 出血