The role of lymph node dissection in the treatment of gastric cancer

Surgery is an effective method in the treatment of stomach cancer. In the early stages of the disease, gastric lymph node dissection and laparoscopic surgery are often used. For advanced gastric cancer cases, laparoscopic gastric bypass surgery is also commonly used.

Previously, open gastrectomy was the only method of treatment for gastric cancer. The disadvantages of this method are a lot of damage, loss of blood, pain, and a long recovery time. With the development of modern medicine, less invasive laparoscopic surgery is more and more developed and widely used.
In patients with early gastric cancer, patients have low risk of lymph node metastasis, so endoscopic gastrointestinal surgery is the first choice, especially in Japan and Korea. Although the long-term oncological results of this method are still being studied, laparoscopic surgery for early gastric cancer is being used very popularly around the world.
Besides, many countries also have a view of widespread lymphadenectomy in gastric cancer with the technical term of D2 lymphadenectomy. Means gastrectomy and removal of lymph node groups in stage 1 (R1) and stage 2 (R2). In some cases, an enlarged D2 lymph node dissection may be necessary, i.e. removal of an additional part of the node at stage 3 (R3).

Indications: Stomach cancer; Chronic peptic ulcer with pyloric stenosis, repeated gastrointestinal bleeding, ineffective medical treatment; Gastric antrum cancer; Cancer of the small curvature of the stomach has not gone beyond the small curvature; Other cancers of the lower stomach area; pyloric stenosis, gastric bleeding due to low-grade cancers of the stomach are eligible for laparoscopic surgery; Tumor no more than 4cm. Contraindications: Patients who are allergic to anesthetics, are not qualified for anesthesia; Tumor is too large over 5cm; Tumor is located high above the small curvature angle, there is no biopsy in surgery to check the gastrectomy area.

3.1. Preoperative preparation The patient will undergo a thorough examination to determine if he or she is eligible for surgery. Before surgery, the patient needs to fast completely and clean the whole body.
3.2. Surgical procedure The patient is under endotracheal anesthesia; Place the trocar and instruments on the umbilical region, aim for the stomach, identify the lesion and diagnose the surgery; Dissection of the lower part of the stomach; Hemostasis, cut off the left and right gastric pedicles, the small curvature of the omentum and the great curvature close to the base to conduct combined lymph node dissection; Dredging lymph nodes according to the specified area; Gastrectomy by automatic or manual splicing machine; Make an anastomosis connecting the gastric apex with the first loop of the jejunum; Close the trocar hole.

Less invasive; Patients have less pain; Less blood loss than open surgery; Shorten recovery time and hospital stay; High aesthetics; Minimize the risk of infection and complications after surgery; The survival time after surgery is improved; It is a safe and effective treatment for advanced gastric cancer. Laparoscopic gastrectomy with D2 lymph node dissection should be performed in large hospitals, which are fully equipped with modern equipment, advanced medical equipment, well-trained and highly specialized surgeons and doctors. experienced in laparoscopic gastrectomy with lymph node dissection.
Vinmec International General Hospital is applying laparoscopic gastrectomy and lymph node dissection in the treatment of gastric cancer and peptic ulcer disease. Surgery is performed by a team of highly qualified, experienced and well-trained doctors; system of modern medical equipment, ensuring sterilization standards, maximum support for treatment efficiency.
For detailed advice on stomach cancer treatments at Vinmec, please come directly to Vinmec health system or register online HERE.
SEE ALSO:
In what cases need gastrectomy? What happens after total gastrectomy for cancer treatment? Possible complications during gastric bypass surgery