The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

D2/D3 Gastrectomy and Lymph Node Dissection

Radical oncological surgery for gastric cancer with extended lymphadenectomy.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is D2/D3 Gastrectomy and Lymph Node Dissection?

D2 gastrectomy is the standard oncological technique for gastric cancer in which, in addition to perigastric lymph nodes, the celiac trunk, left gastric, common hepatic, splenic artery and hepatoduodenal ligament lymph nodes (N2) are removed.

D3 dissection extends to paraaortic lymph nodes (16a2/b1) and is performed in selected advanced cases. Techniques pioneered in Japan are now accepted as standard practice in Western centres.

D2 lymphadenectomy significantly improves 5-year survival and reduces local recurrence in gastric cancer. In experienced centres, mortality of D2 gastrectomy has fallen to 2-3%.

Symptoms

Resectable gastric adenocarcinoma
T2-T4 stage gastric cancer
Clinically node-positive disease
Proximal, mid and distal gastric tumours
Signet ring cell carcinoma
Resectable cases without dissemination
Good performance status
Resectability after neoadjuvant therapy

Risk Factors

Pancreatic fistula (5-10%)
Splenic vein thrombosis
Anastomotic (oesophagojejunal) leak
Duodenal stump dehiscence
Massive haemorrhage
Prolonged operative time
Malnutrition and advanced age
Postoperative weight loss

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Fever and abdominal pain
  • Enteric or biliary fluid in drains
  • Early satiety and vomiting
  • Fresh bleeding or melaena
  • Dysphagia (anastomotic stricture)
  • Excessive weight loss

Treatment Methods

01
Preoperative staging (PET-CT, endoscopic ultrasound)
02
Neoadjuvant chemotherapy (FLOT regimen)
03
Decision between total or subtotal gastrectomy
04
D2 lymphadenectomy (stations No. 1-12)
05
Spleen-preserving splenic hilar dissection
06
Roux-en-Y oesophagojejunostomy reconstruction
07
Feeding jejunostomy (in selected cases)
08
Early postoperative enteral nutrition

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Genel Cerrahi Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Appendicitis

Genel Cerrahi

Appendicitis is inflammation of the appendix causing severe pain in the lower right abdomen. Early diagnosis and surgical treatment are life-saving.

Inguinal Hernia

Genel Cerrahi

Inguinal hernia is the protrusion of intestine or fat into the inguinal canal due to weakness in the abdominal wall. It can be permanently corrected with surgical treatment.

Umbilical Hernia

Genel Cerrahi

Umbilical hernia manifests as a soft swelling around the navel. While it often resolves spontaneously in infants, surgical treatment may be required in adults.

Gallstones and Cholecystectomy

Genel Cerrahi

Gallstones cause severe pain in the upper right abdomen, especially after fatty meals. They are safely treated with laparoscopic cholecystectomy.

Hemorrhoids (Piles)

Genel Cerrahi

Hemorrhoids result from swelling of the veins in the anus; they present with blood on toilet paper, itching, and pain. Various treatments are available, from lifestyle changes to surgery.

Anal Fissure

Genel Cerrahi

Anal fissure is a tear in the thin skin of the anal canal. It presents with sharp pain and bleeding and can be healed with medical or surgical treatment.

Pilonidal Sinus

Genel Cerrahi

Pilonidal sinus consists of tunnels and tracts prone to chronic infection, formed by hair becoming embedded under the skin in the tailbone area. Surgical treatment provides a permanent solution.

Thyroid Surgery

Genel Cerrahi

Thyroid surgery involves the removal of part or all of the thyroid gland for indications such as benign nodules, goiter, and thyroid cancer.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.