关键词: 胃癌, 幽门下淋巴结, 淋巴结清扫, 腹腔镜手术

Abstract: In radical gastrectomy for gastric cancer, standardized dissection of the infrapyloric lymph nodes (No.6) is crucial. Based on the vascular system of infrapyloric region, the infrapyloric lymph nodes are systematically divided into three subgroups: No.6v (around the right gastroepiploic vein), No.6a (around the right gastroepiploic artery), and No.6i (around the infrapyloric arteries). During the dissection procedure, the surgeon must accurately identify the vascular course, using adjacent structures such as the duodenum, pancreas, and mesocolon as anatomical landmarks, and select the correct dissection plane within the mesenteric space. The vascular branches should be meticulously ligated in sequence, and each subgroup of lymph nodes should be thoroughly dissected while avoiding damage to adjacent organs. Advanced technologies including robotic surgical systems, CT-based 3D vascular reconstruction, fluorescence imaging, and nanocarbon tracing navigation, enhance the precision and safety of lymph node dissection.

Key words: gastric cancer, infrapyloric lymph nodes, lymph node dissection, laparoscopic surgery