消化性溃疡与胃癌外科治疗english课件.ppt

* * 24 17 * * 25 17 * 26 17 * * * 胃癌的微创手术 – 机器人手术 Robotic surgery 强化临床多学科(multiple disciplinary team , MDT)联合诊疗模式 肿瘤外科 影像诊断科 放疗科 临床营养科 中医科 病理科 介入治疗科 肿瘤内科 谢 谢！ * * Another example is even in the same country, its incidence was also varies from area to area. In China, for instance, red areas was the area with remarkably high GC mortality rate, including GanSu, Qinghai, Jilin, some eastern costal line provinces. While area was the area with lowest mortality area, including Guangdong, Guangxi Yunnan provinces. * * * * * * * * * * * * * * * * * * * * * * * * * * * I 型 II型 III型 Ⅳ型 Polyps diffuse type Linitis plastica Ulcerating carcinoma Polypoid carcinoma EGC,excavated GIST Histological types Mainly adenocarcinoma Papillary adeno-ca tubular adeno-ca mucinous adeno-ca signet-ring cell ca Squamous cell carcinoma Undifferentiated carcinoma Carcinoid tumor Metastatic Route Direct invasion Lymphatic spread Metastasis by bloodstream Peritoneal implantation Free cancer cell (FCC) Krukenberg’s Tumor Location: AMC, MAC, MCA, CMA Grouping of lymph nodes used in surgical dissection Site of Tumor AMC. MAC A. AM MA. M. C. CM MCA. CMA MC Group 1 (1) (2) (3) (3) (4) (5) (3) (4) (5) (1) (2) (3) (N1) (4) (5) (6) (6) (6) (1) (4) Group 2 (7) (8) (9) (7) (8) (9) (2) (7) (8) (7) (8) (9) (N2) (10) (11) (1) (9) (10) (11) (10) (11) (5) (6) Group 3 (12) (13) (14) (2) (10) (11) (12) (13) (14) (12) (13) (14) (N3) (15) (12) (13) (14) (15) (15) (15) Group 4 (16) (16) (16) (16) (N4) TNM Staging T--- primary tumor N--- regional lymph node M--- metastases Procedures for Assessing T, N, M T categories Physical examination ,imaging, endoscopy, and/or surgical exploration, pathological finding N categories Physical examination ,imaging, and/or surgical exploration, pathological finding M categories Physical examination, imaging, and/or surgical exploration, patholog