[Surgical strategies of radical gastrectomy for gastric cancer in the era of immunotherapy].

Immunotherapy has become the first-line standard treatment regimen for advanced gastric cancer. The neoadjuvant immunotherapy for locally advanced gastric cancer is currently undergoing clinical research. Preliminary results show that, compared with neoadjuvant chemotherapy, after neoadjuvant immunotherapy (combined with chemotherapy/combined with chemotherapy and targeted therapy/combined with chemotherapy and radiotherapy/ double immunotherapy), the pathological complete response rate of patients after surgery has been significantly improved. The regional lymph nodes around the stomach play a crucial role in the curative effect of immunotherapy. For cases with clinical judgment of clinical partial response (cPR) or clinical complete response (cCR), it is import ant to appropriately reduce the scope of gastric resection and the extent of lymph node dissection to avoid excessive removal of normal lymph nodes, which is crucial for the subsequent curative effect of immunotherapy on patients. In the era of immunotherapy, based on clinical practice, the extent of D2 lymph node dissection in the era of dominated by surgery should be re-evaluated. On the premise of ensuring the quality of the surgery, this can enable patients to avoid excessive surgery, reduce relevant surgical trauma, improve the safety during the perioperative period, and enhance the patients ' quality of life.