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胃癌根治手术的原则就是将胃癌原发病灶连同部分胃组织及相应区域淋巴结全部切除,根据区域淋巴结清扫范围分为R_1、R_2、R_3、R_4。对于进展期胃癌一般以原病灶切除伴随R_2清扫为原则。为了达到绝对性根治手术治疗,R_3、R_4清扫及合并脏器切除即为扩大根治手术,对第四站淋巴结即腹主动脉周围淋巴结治疗性和预防性清扫,是提高进展期胃癌5年生存率的关键。
The principle of radical gastrectomy for gastric cancer is to remove the primary gastric cancer together with part of gastric tissue and corresponding regional lymph nodes, and divide it into R_1, R_2, R_3, and R_4 according to regional lymph node dissection. For advanced gastric cancer, the principle of primary resection combined with R_2 dissection is generally adopted. In order to achieve absolute radical surgery, R_3, R_4 dissection and visceral resection are extended radical operations. The fourth-station lymph node, ie, the therapeutic and prophylactic cleaning of the lymph nodes around the abdominal aorta, is to improve the 5-year survival rate of advanced gastric cancer. key.