expansivegrowthpattern(Types1and2)a

expansivegrowthpattern(Types1and2)and5cmisrec- ommendedforthosewithinfiltrativegrowthpattern(Types3 and4).Whentheserulescannotbeobserved,itisadvisable toexaminetheproximalresectionmarginbyfrozensection. Fortumorsinvadingtheesophagus,a5-cmmarginisnot necessarilyrequired,butfrozensectionexaminationofthe resectionlineisdesirabletoensureanR0resection.
ForT1tumors,agrossresectionmarginof2cmshould beobtained.Whenthetumorborderisunclear,preopera- tiveendoscopicmarking,byclips,ofthetumorborder basedonbiopsyresultswillbehelpfulfordecision-making regardingtheresectionline.
2.2.2.2Selectionofgastrectomy Thestandardsurgical procedureforclinicallynode-positive(cN?)orT2-T4a tumorsiseithertotalordistalgastrectomy.Distalgastrectomy isselectedwhenasatisfactoryproximalresectionmargin(see above)canbeobtained.Pancreaticinvasionbytumor requiringpancreaticosplenectomynecessitatestotalgastrec- tomyregardlessofthetumorlocation.Totalgastrectomywith splenectomyshouldbeconsideredfortumorsthatarelocated alongthegreatercurvatureandharbormetastasistono.4sb lymphnodes,eveniftheprimarytumorcouldberemovedby distalgastrectomy.Foradenocarcinomalocatedontheprox- imalsideoftheesophagogastricjunction,esophagectomyand proximalgastrectomywithgastrictubereconstructionshould beconsidered,similarlytosurgeryforesophagealcancer.
ForcT1cN0tumors,gastricresectioncanbemodifiedas followsaccordingtotumorlocation.
– Pylorus-preservinggastrectomy(PPG) fortumorsin themiddleportionofthestomachwiththedistaltumor borderatleast4cmproximaltothepylorus.
– Proximalgastrectomy forproximaltumorswheremore thanhalfofthedistalstomachcanbepreserved.
Segmentalgastrectomyandlocalresectionarestill regardedasinvestigationaltreatments.
2.3Lymphnodedissection
2.3.1Extentoflymphnodedissection
Theextentofsystematiclymphadenectomyisdefinedas followsaccordingtothetypeofgastrectomyindicated. Whenthelymphadenectomyperformeddoesnotcomply withtheDlevelcriteria(eitherwhenlymphnodesoutside therequirementfortheDcriteriaareresectedorwhen nodaldissectionisinsufficienttofulfillthecriteria),the lymphnodestationthathasbeendissectedoromitted
shouldbespecified,asinthefollowingexamples:D1 (?No.8a),D2(-No.10).Whenreportingthedatato constructaformaldatabase,onlytheDlevelthathasbeen completelyresectedshouldbeprovided.
2.3.1.1Totalgastrectomy
D0:LymphadenectomylessthanD1 D1:Nos.1–7 D1?:D1? Nos.8a,9,11p D2:D1 ? Nos.8a,9,10,11p,11d,12a.
Fortumorsinvadingtheesophagus,D1? includesNo. 1101,D2includesNos.19,20,110,and111.

4d 4sb
6 3
5 7
12a 9
1
2
4sa
8a 11p 11d 10
2.3.1.2Distalgastrectomy
Total gastrectomy
D0:LymphadenectomylessthanD1 D1:Nos.1,3,4sb,4d,5,6,7 D1?:D1? Nos.8a,9 D2:D1 ? Nos.8a,9,11p,12a.

4d 4sb
6 3
5 7
12a 9
1
8a 11p
Distal gastrectomy
1 No.110lymphnodes(lowerthoracicpara-esophagealnodes)in gastriccancerinvadingtheesophagusarethoseattachedtothelower partoftheesophagusthatisremovedtoobtainasufficientresection margin.

Kết quả (Việt) 1:

expansivegrowthpattern (Types1and2) and5cmisrec - ommendedforthosewithinfiltrativegrowthpattern(Types3 and4).Whentheserulescannotbeobserved, itisadvisable toexaminetheproximalresectionmarginbyfrozensection. Fortumorsinvadingtheesophagus, a5-cmmarginisnot necessarilyrequired, butfrozensectionexaminationofthe resectionlineisdesirabletoensureanR0resection.ForT1tumors, agrossresectionmarginof2cmshould beobtained.Whenthetumorborderisunclear, preopera-tiveendoscopicmarking, byclips, ofthetumorborder basedonbiopsyresultswillbehelpfulfordecision làm regardingtheresectionline.2.2.2.2Selectionofgastrectomy Thestandardsurgical procedureforclinicallynode-positive(cN?)orT2-T4a tumorsiseithertotalordistalgastrectomy.Distalgastrectomy isselectedwhenasatisfactoryproximalresectionmargin (xem ở trên) canbeobtained.Pancreaticinvasionbytumor requiringpancreaticosplenectomynecessitatestotalgastrec-tomyregardlessofthetumorlocation.Totalgastrectomywith splenectomyshouldbeconsideredfortumorsthatarelocated alongthegreatercurvatureandharbormetastasistono.4sb lymphnodes, eveniftheprimarytumorcouldberemovedby distalgastrectomy.Foradenocarcinomalocatedontheprox-imalsideoftheesophagogastricjunction, esophagectomyand proximalgastrectomywithgastrictubereconstructionshould beconsidered, similarlytosurgeryforesophagealcancer.ForcT1cN0tumors, gastricresectioncanbemodifiedas followsaccordingtotumorlocation.-Pylorus-preservinggastrectomy(PPG) fortumorsin themiddleportionofthestomachwiththedistaltumor borderatleast4cmproximaltothepylorus.-Proximalgastrectomy forproximaltumorswheremore thanhalfofthedistalstomachcanbepreserved.Segmentalgastrectomyandlocalresectionarestill regardedasinvestigationaltreatments.2.3Lymphnodedissection2.3.1ExtentoflymphnodedissectionTheextentofsystematiclymphadenectomyisdefinedas followsaccordingtothetypeofgastrectomyindicated. Whenthelymphadenectomyperformeddoesnotcomply withtheDlevelcriteria (eitherwhenlymphnodesoutside therequirementfortheDcriteriaareresectedorwhen nodaldissectionisinsufficienttofulfillthecriteria), lymphnodestationthathasbeendissectedoromittedshouldbespecified, asinthefollowingexamples:D1 (?No.8A),D2(-No.10).Whenreportingthedatato constructaformaldatabase, onlytheDlevelthathasbeen completelyresectedshouldbeprovided.2.3.1.1TotalgastrectomyD0:LymphadenectomylessthanD1 D1:Nos.1–7 D1?: D1? Nos.8A,9,11p D2:D1? Nos.8A,9,10,11p,11d,12A.Fortumorsinvadingtheesophagus, D1? includesNo. 1101,D2includesNos.19,20,110,and111.4d 4sb6 35 712A 9124SA8A 11p 11 d 102.3.1.2DistalgastrectomyTổng số gastrectomyD0:LymphadenectomylessthanD1 D1:Nos.1,3,4sb,4d,5,6,7 D1?: D1? Nos.8A,9 D2:D1? Nos.8A,9,11p,12A.4d 4sb6 35 712A 918A 11pGastrectomy xa1 No.110lymphnodes (lowerthoracicpara-esophagealnodes) ở gastriccancerinvadingtheesophagusarethoseattachedtothelower partoftheesophagusthatisremovedtoobtainasufficientresection lề.

Kết quả (Việt) 2:

expansivegrowthpattern (Types1and2) and5cmisrec- ommendedforthosewithin fi ltrativegrowthpattern (Types3 and4) .Whentheserulescannotbeobserved, toexaminetheproximalresectionmarginbyfrozensection itisadvisable. Fortumorsinvadingtheesophagus, a5-cmmarginisnot necessarilyrequired, butfrozensectionexaminationofthe resectionlineisdesirabletoensureanR0resection.
ForT1tumors, agrossresectionmarginof2cmshould beobtained.Whenthetumorborderisunclear, tiveendoscopicmarking preopera-, byclips, ofthetumorborder basedonbiopsyresultswillbehelpfulfordecision làm regardingtheresectionline.
2.2.2.2Selectionofgastrectomy Thestandardsurgical procedureforclinicallynode dương (cN?) orT2-T4a tumorsiseithertotalordistalgastrectomy.Distalgastrectomy isselectedwhenasatisfactoryproximalresectionmargin (xem ở trên) canbeobtained.Pancreaticinvasionbytumor requiringpancreaticosplenectomynecessitatestotalgastrec- tomyregardlessofthetumorlocation.Totalgastrectomywith splenectomyshouldbeconsideredfortumorsthatarelocated alongthegreatercurvatureandharbormetastasistono.4sb lymphnodes, eveniftheprimarytumorcouldberemovedby distalgastrectomy.Foradenocarcinomalocatedontheprox- imalsideoftheesophagogastricjunction, esophagectomyand proximalgastrectomywithgastrictubereconstructionshould beconsidered, similarlytosurgeryforesophagealcancer.
ForcT1cN0tumors, gastricresectioncanbemodi fi EDA followsaccordingtotumorlocation.
- môn vị-preservinggastrectomy (PPG) fortumorsin themiddleportionofthestomachwiththedistaltumor borderatleast4cmproximaltothepylorus.
- Proximalgastrectomy forproximaltumorswheremore thanhalfofthedistalstomachcanbepreserved.
Segmentalgastrectomyandlocalresectionarestill followsaccordingtothetypeofgastrectomyindicated. Whenthelymphadenectomyperformeddoesnotcomply withtheDlevelcriteria (eitherwhenlymphnodesoutside therequirementfortheDcriteriaareresectedorwhen nodaldissectionisinsuf fi cienttoful fi llthecriteria), các lymphnodestationthathasbeendissectedoromitted shouldbespeci fi ed, asinthefollowingexamples: D1 (No.8a?), D2 (-No.10) .Whenreportingthedatato constructaformaldatabase, onlytheDlevelthathasbeen completelyresectedshouldbeprovided. 2.3.1.1Totalgastrectomy D0: LymphadenectomylessthanD1 D1: Nos.1-7 D1: D1? Nos.8a, 9,11p D2: D1? Nos.8a, 9,10,11p, 11d, 12a. Fortumorsinvadingtheesophagus, D1? includesNo. . 1101, D2includesNos.19,20,110, and111 4sb 4d 6 3 5 7 9 12a 1 2 4sa 8a 11p 11d 10 2.3.1.2Distalgastrectomy Tổng cắt dạ dày D0: LymphadenectomylessthanD1 D1: Nos.1,3,4sb, 4d, 5,6, 7 D1: D1? Nos.8a, 9 D2: D1? Nos.8a, 9,11p, 12a. 4d 4sb 6 3 5 7 9 12a 1 8a 11p cắt dạ dày xa 1 No.110lymphnodes (lowerthoracicpara-esophagealnodes) trong gastriccancerinvadingtheesophagusarethoseattachedtothelower partoftheesophagusthatisremovedtoobtainasuf lề fi cientresection.