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The Stomach
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Curative surgery for gastric carcinoma differs from that for benign conditions. The resection must include wide resection of the stomach with a wide portion of the normal adjacent tissues, the greater and lesser omentums, and the regional lymph nodes. The major lymphatic channels run together with the left gastric, splenic, and hepatic arteries. The regional lymph node areas include the lesser and greater curvatures (omentums), juxtacardiac, gastroduodenal, supra- and subpylorie (pancreaticoduodenal), and celiac, splenic, and hepatic lymph nodes. Since submucosal lymphatic spread is common, the resection margins should always be checked by frozen section at the time of surgery and should be free of tumor.
Dynamics of Lymph Formation and its Modification
Published in Waldemar L. Olszewski, Lymph Stasis: Pathophysiology, Diagnosis and Treatment, 2019
Thomas H. Adair, Jean-Pierre Montani
Studies of a different nature from other laboratories122,129–131 indicate that many sheep lymph nodes have the ability to change the lymph protein concentration in a manner similar to that found for the dog popliteal node. Quin and Shannon122 compared the normal afferent and efferent lymph protein concentrations for the popliteal, renal, precapsular, and hepatic nodes in chronically instrumented awake sheep. Figure 6 shows averaged data extracted from the Quin and Shannon study122 where percent change in lymph protein concentration is expressed as a function of afferent lymph to plasma colloid osmotic pressure ratio. The popliteal, renal, and precapsular lymph nodes receiving lymph having a low colloid osmotic pressure concentrated the lymph proteins; whereas, the hepatic lymph node receiving concentrated lymph diluted the lymph. Note the striking similarities between the results obtained from the various sheep lymph nodes (see Figure 6) and those from the dog popliteal lymph node (see Figure 5). Both figures show that lymph may become concentrated or diluted during nodal transit, depending on the colloid osmotic pressure of the afferent lymph. The equation for the curve shown on Figure 6 indicates that lymph having a colloid osmotic pressure equal to 62% of that of plasma would not be altered during transit through the various sheep lymph nodes. This value is incredibly close to the curve averaged equilibrium colloid osmotic pressure of the dog popliteal node, a value averaging 57% of that of plasma as shown on Figure 5.
Gastrointestinal Function and Toxicology in Canines
Published in Shayne C. Gad, Toxicology of the Gastrointestinal Tract, 2018
The duodenum receives its blood supply from both the cranial and caudal pancreaticoduodenal arteries. The jejunum receives its blood supply from approximately 12 to 15 jejunal arteries, which originate from the cranial mesenteric artery. The ileum receives its blood supply on its antimesenteric side via branches extending from the ileocecal artery and on the mesenteric side by the accessory cecal artery. It should be mentioned that the duodenum receives a richer blood supply than the ileum. Perhaps this is because the duodenum produces more fluid than the ileum, an amount approaching ten times as much. The veins draining the small intestine are satellites of the arteries supplying the organ. Lymph vessels from the duodenum drain into the hepatic lymph nodes and the variably present duodenal lymph node, while lymphatics from the jejunum drain into the right and left mesenteric lymph nodes. The ileum’s lymphatics empty into the right and left mesenteric lymph nodes and the colic lymph nodes.
The evolving management of small bowel adenocarcinoma
Published in Acta Oncologica, 2018
Eelco de Bree, Koen P. Rovers, Dimitris Stamatiou, John Souglakos, Dimosthenis Michelakis, Ignace H. de Hingh
For duodenal tumors, a Whipple resection should be performed for a tumor located in the second segment of the duodenum or for an infiltrating tumor in the proximal or distal duodenum. Additionally, resection of the periduodenal, peripancreatic and hepatic lymph nodes should also be performed, as well as resection of the right side of the celiac and superior mesenteric arteries. A duodenal resection alone could be performed for a proximal duodenal tumor or a distal duodenal tumor with no infiltration of adjacent organs, despite the fact that this procedure is associated with poor prognosis [42]. An R0 resection is to be preferred, as R1 or R2 resections are strongly associated with poor prognosis [43]. For jejunal and ileal tumors, an R0 resection with lymph node resection and jejuno–jejunal or ileo–ileal anastomosis should be performed. If the last ileal loop or Bauhin’s valve is involved, an ileocecal resection or right hemicolectomy should be performed with ligation of the ileocolic artery so as to allow for adequate lymph node resection.
Adenosquamous carcinoma of the digestive system: a literature review
Published in Scandinavian Journal of Gastroenterology, 2020
Hong-Shuai Li, Tao He, Li-Li Yang
(3) Lymph node metastasis: ASC has a high potential for local metastases, and the rate of lymph node positivity is significantly higher in ASC than in conventional pathological types [75–81]. Yan et al. [86] found that the rate of hepatic lymph node metastasis from ASC was as high as 44.4%, compared with only 17.5% for that from hepatocellular carcinoma.