Standard and extended lymphadenectomy: technical notes

Surgical procedures for the dissection of the various lymph nodes stations differ depending on the location and stage of the gastric tumor. The guidelines of the Japanese Gastric Cancer Association recommend D2 (standard) lymphadenectomy for the treatment of advanced gastric carcinoma. However, an emerging surgical approach to the treatment of gastric tumors is the D3 (extended) lymphadenectomy, indicated for advanced cancers and in patients in good general health who are under 75 years of age. In this chapter, we discuss the D2 standard and D3 extended surgical techniques for the treatment of advanced gastric carcinoma.