Lewis Katz School of Medicine at St Lukes University Health Network, 800 Ostrum Street, Bethlehem, PA 18015, USA.
Lewis Katz School of Medicine at St Lukes University Health Network, 800 Ostrum Street, Bethlehem, PA 18015, USA; Temple University School of Medicine, Bethlehem, PA, USA.
Surg Clin North Am. 2025 Feb;105(1):47-54. doi: 10.1016/j.suc.2024.06.005. Epub 2024 Sep 6.
Current treatment for gastric cancer includes a multidisciplinary approach of systemic therapy and surgery. While retrospective, prospective, and randomized trials have demonstrated conflicting results on the need for extended lymphadenectomy, current guidelines dictate a recommendation for the retrieval of at least 16 lymph nodes to accurately stage patients. The "D1" lymph nodes along the major gastric and epiploic vessels may provide adequate lymph node harvest, though "D2" lymphadenectomy along the celiac axis and its branches may be necessary. Performing a distal pancreatectomy and splenectomy to maximize the D2 nodal harvest is not necessary and leads to increased morbidity.
目前，胃癌的治疗包括多学科的系统治疗和手术。虽然回顾性、前瞻性和随机试验对扩大淋巴结清扫的必要性得出了相互矛盾的结果，但目前的指南规定至少要获取 16 个淋巴结以准确分期患者。沿胃大血管和网膜血管的“D1”淋巴结可以提供足够的淋巴结清扫，但沿腹腔干及其分支的“D2”淋巴结清扫可能是必要的。为了最大限度地获取 D2 淋巴结而进行远端胰腺切除术和脾切除术是没有必要的，而且会导致更高的发病率。
