Regional lymphatic metastasis in early gastric cancer

Masanori Kobayashi, Shigekazu Ohyama, Keiichiro Ohta, Toshiki Matsubara, Hirotoshi Ohta, Takashi Takahashi and Toshifusa Nakajima

Department of Surgery Cancer Institute Hospital

We mapped the arterial areas of lymphatic drainage, by studying cases of single lymphonode metastasis of early gastric cancer. Arterial areas of lymphtic drainage are divided into four areas according to the arteries that supply the stomach (left gastric arterial area, right gastroepiplolic arterial area, splenic arterial area, and right gastric arterial area). The left gastric arterial area is the largest of the four. and extends to the whole stomach expcept for the greater curvature of the upper one-third of the stomach and pylorus. The right gastric arterial area is small and includes the lesser curvature of the antrum. The splenic arterial area is also small and extends to the greater curvature of the upper two-thirds of the stomach. From the lesser curvature of the lower body and the greater curvature of the middle body and the greater curvature of the middle body to the antrum, the left gastric arterial and right gastroepiploic arterial areas overlap. Tumors located in these overlapped areas have the possibility of metastasizing to the lymphonodes of either area. Therefore, it is necessary to dissect the lymphnodes of these overlapped areas. In conclusion, the map of arterial areas of lymphatic drainage should be used to discuss the extent of resection and dissection.

Key words
regional lymphatic metastasis, limited lymph node dissection, early gastric cancer

Reprint requests
Masanori Kobayashi Department of Surgery, Tone Central Hospital 1855-1 Higashiharashinmachi, Numata-city, 378-0053 JAPAN

Accepted
March 31, 1999

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