Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea.
Chin J Cancer Res. 2014 Jun;26(3):231-3. doi: 10.3978/j.issn.1000-9604.2014.06.15.
Qualified radical gastrectomy with lymph node dissection is very important to the prognosis of patients with gastric cancer. Now D2 lymph node dissection is standard procedure for gastric cancer surgery, and spleen hilar lymph node dissection is mandatory for gastric cancer in upper body. Because the anatomy of vessels in this area is very complicated, D2 lymph node dissection is technical challenging not only for open gastrectomy but also for laparoscopic one. Adapting a new technique is important to all surgeons, but we surgeons should always consider a patient's safety as the most important factor during surgery and that efforts should be based on scientific rationale with oncologic principles. I hope that the recent report by Huang et al. about laparoscopic spleen preserving hilar lymph node dissection would be helpful to young surgeons who will perform laparoscpic total gastrectomy for gastric cancer.
行规范性根治性胃切除术并进行淋巴结清扫对胃癌患者的预后非常重要。目前，D2 淋巴结清扫术已成为胃癌手术的标准术式，对于上腹部胃癌，必须进行脾门淋巴结清扫。由于该区域血管解剖结构非常复杂，D2 淋巴结清扫术不仅对开腹手术，而且对腹腔镜手术都是极具技术挑战性的。对于所有外科医生来说，采用新技术很重要，但我们外科医生在手术过程中始终应将患者的安全视为最重要的因素，并且应该在基于肿瘤学原则的前提下，进行有科学依据的努力。我希望黄等人最近关于腹腔镜保留脾脏的脾门淋巴结清扫术的报告对将要进行腹腔镜全胃切除术的年轻外科医生有所帮助。
