D2 Lymphadenectomy for Gastric Cancer: Advancements and Technical Considerations.

Autor: Dehal A; Department of General Surgery, Southern California Permanente Medical Group, Department of Clinical Sciences, Kaiser Permanente School of Medicine, Los Angeles, CA, USA. ahmed.n.dehal@kp.org., Woo Y; Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, USA., Glazer ES; Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA., Davis JL; Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Strong VE; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2024 Nov 26. Date of Electronic Publication: 2024 Nov 26.
DOI: 10.1245/s10434-024-16545-6
Abstrakt: Lymphadenectomy (LND) is a crucial component of the curative surgical treatment of gastric cancer (GC). The LND serves to both accurately stage the disease and offer therapeutic benefits. At the time of "curative-intent" gastrectomy, D2 LND is the optimal treatment for patients with locally advanced GC due to its survival benefits and acceptable morbidity. Mastery of the technical aspects of LND, especially D2, requires significant training, adequate case volume, and expertise. This review discusses key aspects of D2 LND, including its status as the standard treatment for locally advanced GC, definition and anatomic borders, technical details, and controversial topics such as splenic hilar dissection and omentectomy. The application of indocyanine green (ICG) fluorescence imaging to elucidate the drainage patterns of GC and to facilitate lymph node (LN) identification is briefly reviewed. Finally, GC standardization and centralization, including surgical treatment, are discussed.
Competing Interests: Disclosures: Vivian Strong has received speaking honoraria from Merck and Regeneron. The remaining authors have no conflicts of interest.
(© 2024. Society of Surgical Oncology.)
Databáze: MEDLINE
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