Anatomy of the lymphoid system in relation to upper gastrointestinal cancer surgery

Abstract

The lymphoid system is essential to maintain normal physiology, but also provides a major route for the spread of cancer cells. Consequently, it is an important target during gastrointestinal oncologic surgery. Adequate knowledge of lymphatic anatomy is essential both for predicting cancer dissemination pathways and diminishing postoperative lymphatic complications. However, several knowledge gaps pertaining to the anatomy of the lymphoid system exist. Therefore, the research presented in this thesis aimed to investigate the anatomy of the lymphoid system and its involvement in both esophageal and gastric cancer surgery. The included studies encompass anatomical, histological, and (prospective) cohort studies of which the results exemplified the importance of the lymphoid system in upper gastrointestinal cancer surgery. The results contribute to a more radical resection and lead to a reduction of postoperative lymphatic complications.