胃癌腹腔镜手术近远期疗效的循证医学评价

Evaluations of evidence-based medicine on short and long-term outcomes of laparoscopic gastrectomy for gastric cancer

治疗胃癌的腹腔镜胃切除手术（laparoscopic gastrectomy,LG）在过去的20年中运用范围日益广泛。相关的循证医学结果显示,在近期疗效方面,LG 已达到不低于开腹胃切除手术（open gastrectomy,OG）的肿瘤临床治疗效果,且具有微创等优势。在远期疗效方面,LG 与 OG 治疗早期胃癌相近的疗效已获得了充足的循证医学证据,LG 已成为早期胃癌可选的标准治疗方法之一。虽然不少研究显示 LG 治疗进展期胃癌亦能取得 OG 同样的远期疗效,但仍缺乏多中心的前瞻性随机对照研究结果来评价腹腔镜手术的优劣。外科医师只有严格选择合适病例,手术中严格遵循恶性肿瘤手术的根治原则,才能使腹腔镜胃癌根治术在取得微创优势的基础上具有与开腹手术相当的疗效。

Laparoscopic gastrectomy （LG）has gained its popularity over the past two decades. In term of short-term efficacies,many studies have demonstrated that LG,more mini-invasive,is as clinically effective as open gastrectomy （OG）.As for long-term efficacies,both LG and OG are effica-cious for early gastric cancer.Despite comparable outcomes of both methods for advanced gastric canc-er,no multi-center,prospective and randomized control study is available for evaluating the effective-ness of LG.Surgeons should carefully select optimal patients and strictly follow the protocols for trea- ting malignant cancer.In doing so,LG may achieve oncologic outcomes equivalent to those of conven-tional OG.