浅谈胃癌D2淋巴结清扫中的副损伤

Brief discussion on prevention of the secondary damage in the procedures of D2 lymphadenectomy for gastric cancer

D2淋巴结清扫,是目前公认的胃癌根治性手术中重要的操作步骤,其规范地实施可直接影响整个胃癌根治术质量和患者预后.淋巴结清扫是胃癌外科局部治疗的重要基础,鉴于其解剖位置及与邻近脏器、血管等存在的复杂关系甚至出现变异,淋巴结清扫存有一定风险和技术难度,学习曲线的经历是必然的.即使对于临床经验丰富的外科医师而言,D2淋巴结清扫仍然不可避免地会出现一定的副损伤.遵守规范操作、且不断总结每例胃癌根治术中D2淋巴结清扫的要点,是减少或避免术后相关并发症出现的主要方法.

So far, D2 lymphadenectomy has been recognized as the key one of the procedures in curative resection for gastric cancer. In summary, the standardized implementation of D2 lymphadenectomy can contribute to both surgical quality and patients′ prognosis. Lymph node dissection, as an important basis for local surgical treatment of gastric cancer, involves certain technical risks due to complex adjacent relationship and anatomical variation of organs or blood vessels, and so on. There is a certain incidence of side injuries in D2 lymphadenectomy for a surgeon, regardless of the experience of learning curve. Complying with specification of surgical procedures and summarizing the vital points of lymph node dissection in each curative gastrectomy for gastric cancer is the principal method to reduce or avoid the occurrence of relevant complications after surgery.