进展期胃癌淋巴结清扫规范化实施与质量控制

Standardized implementation and quality control of lymph node dissection in advanced gastric cancer

  • 摘要: 淋巴结转移是胃癌最主要的转移途径,是影响患者分期、治疗决策及长期预后的关键因素。规范化D2淋巴结清扫术不仅有助于彻底廓清潜在转移灶,也是获得准确病理学分期和指导后续治疗的重要基础。随着胃癌精准外科理念的发展,淋巴结清扫策略已从单纯强调清扫范围,逐步转向更加重视清扫质量。笔者围绕胃癌淋巴结清扫范围的规范化选择、高质量D2淋巴结清扫术的技术基础、质量评价体系以及新辅助治疗时代的淋巴结清扫策略等话题进行探讨。笔者认为:标准D2淋巴结清扫术仍是目前局部进展期胃癌外科治疗的基石,未来应在此基础上,通过标准化手术流程、客观化质量评价体系和精准化综合治疗策略的实施,实现肿瘤学获益与手术安全性的最佳平衡。

     

    Abstract: Lymph node metastasis is one of the major metastatic pathways in gastric cancer and is a key determinant of tumor staging, treatment decision‑making, and long‑term prognosis. Standardized D2 lymphadenectomy not only facilitates the removal of potential metastatic disease but also provides the basis for accurate pathological staging and subsequent multidisciplinary treatment. With the development of precision surgery concepts for gastric cancer, lymph node dissection strategies have shifted from the extent of dissection to the quality of dissection. The authors discuss the standardized selection of lymphadenectomy extent, technical foundations of high‑quality D2 lymphadenectomy, quality assessment systems, and lymphadenectomy strategies in the era of neoadjuvant therapy. It is believed that standard D2 lymphadenectomy remains the cor-nerstone of surgical treatment for locally advanced gastric cancer. Future efforts should focus on standardized surgical procedures, objective quality assessment systems, and precision treatment strategies to achieve an optimal balance between oncological benefit and surgical safety.

     

/

返回文章
返回