The stomach cancer is the most common malignancy in Korea. The unique method to cure the stomoch cancer is to make early diagnosis of it, but majority of cases settle diagnosis in advanced stage.
Extended radical radical dissection of stomach cancer offers more accurate stage and complete removal of metastatic lymph nodes raises the rate of curability.
It has been revealed for long time that cases with paraaortic lymph nodes metastasis are impossible to be cured. But with several reports of long term survival of cases with paraaortic lymph node metastasis, recently the procedure of paraaortic
dissection prevails in Japan.
To evaluate procedures of paraaortic lymph nodes dissection in the advanced stomach cancer, Author analyzed prospectively 48 cases had paraaortic node dissection in department of surgery, Pusan National University Hospital.
@ES The results were summarized as follows:
@EN 1) The ratio of male to female was 2:1, and in the age incidence, more than 40-year old age were 41 cases(85.6%) and under 40 year-old age were 7 cases(14.6%).
2) The incidence of paraaortic lymph nodes metastasis in relation to the location of primary tumor was 33.3%(4 of 12 cases) in upper third tumor, 25.0%(4 of 16 cases) in diffuse type of stomach cancer, 16%(2 of 12cases) in lower third tumor, and
12.5%(1 of 8 cases) in middle third.
3) In the skip metastasis among lymph nodes in group 1, 2, 3 and paraaortic lymph nodes according to Japanese general rule for the gastric cancer study in surgery and pathology, skip metastasis was not revealed in 53.6% of cases and the rate of
metastasis skipping over lymph nodes in group 3 to paraaortic lymph node was 45.4%.
4) In the incidence of paraaortic lymph nodes metastasis in relation to the number of positive lymph nodes in group 1, 2 and 3, the incidence was 16.7%(1 of 6) when the number of positive nodes was less than 10, 26.7%(4 of 15) when it was more
than 10
and under 15, 35.4%(4 of 11) when it was more than 15 and under 20, and 66.7%(2 of 3) when it was more than 20.
5) In postoperative complication, left pleural effusion, acute pancratitis, and intrraabdominal abscess was in 2 cases(4.2%) respectively, and adhesive ileus requiring operation and sudden death, was in 1 cases(2.1%) respectively.
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