Radical resection of advanced gastric cancer

Radical resection surgery completely removes the primary lesion of gastric cancer, metastatic lymph nodes, and invaded tissues and organs, including radical subtotal gastrectomy and radical total gastrectomy. In recent years, the definition of the scope of gastric resection has basically tended to be consistent, that is, the gastric tangent line should be no less than 5 cm away from the naked eye edge of the tumor. For distal gastric cancer, 3 to 4 cm of the first part of the duodenum should be resected, and for proximal gastric cancer, 3 to 4 cm of the lower esophagus should be resected. In terms of lymph node dissection, most scholars recommend D2.

In recent years, most scholars have advocated that for patients with obvious metastasis to the splenic hilar and splenic artery lymph nodes or tumors that have invaded the pancreatic body and tail and spleen, caudal hemipancreatectomy and splenectomy, or splenic artery and splenectomy with pancreas preservation, can be performed.

For direct spread of gastric cancer and a few lesions or isolated lesions in the liver or liver metastases confined to one lobe of the liver, the perigastric lymph nodes can still be completely removed, and the patient is in good general condition, radical resection of gastric cancer combined with liver resection can be performed.