Strategies for supra-pancreatic lymph node dissection in laparoscopic gastric cancer surgery
10.3760/cma.j.cn441530-20250717-00270
- VernacularTitle:腹腔镜胃癌手术中胰腺上区淋巴结清扫的策略
- Author:
Tianyu JIANG
1
;
Lu ZANG
1
Author Information
1. 上海交通大学医学院附属瑞金医院普通外科 胃肠外科 上海市微创外科临床医学中心 上海市胃肿瘤重点实验室，上海 200025
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Laparoscopy;
Supra-pancreatic lymph node;
Lymphadenectomy
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(9):987-992
- CountryChina
- Language:Chinese
-
Abstract:
Currently, the performance of D2 lymphadenectomy for locally advanced gastric cancer (LAGC) has become an established therapeutic consensus. The accumulating evidence supporting the application of laparoscopic techniques in such procedures signifies the transition of laparoscopic radical gastrectomy from an exploratory phase into mature clinical practice, with the surgical volume showing a yearly increasing trend. Alongside advancements in imaging equipment, innovations in surgical instrument, and updates in therapeutic concepts, surgeons are placing increasing emphasis on the radicality of the operation, the quality of lymph node dissection, and perioperative safety. Lymph node dissection in the supra-pancreatic area along the celiac arterial system constitutes a critical step in radical gastrectomy for gastric cancer. Supra-pancreatic area serves not only as a major lymphatic drainage hub for the stomach but also presents significant surgical challenges due to its complex anatomy, difficult exposure, high risk of bleeding, and injury to vital structures traversing the area. Therefore, how to effectively reduce the difficulty for the assistant to expose, optimize the surgeon's control over the anatomical planes in this region, achieve more refined maneuvers, and consequently reduce bleeding, lower complication rates, and shorten operative time are core issues currently concerning surgeons. This article, based on author's clinical experience, aims to provide an in-depth discussion on the strategies for supra-pancreatic lymph node dissection in laparoscopic gastric cancer surgery.
