微创技术在中国胃癌手术中应用的历史与发展趋势

History and development trend of minimally invasive techniques for gastric cancer in China

以腹腔镜为代表的微创技术是胃癌外科治疗的主要方向之一。自1999年首次报道腹腔镜胃癌手术以来，我国腹腔镜胃癌微创手术经历了初步探索期、快速发展期和日渐成熟期3个阶段。虽然目前我国开展腹腔镜胃癌微创手术的单位越来越多，报道的例数逐年增加，也取得了满意的临床疗效，但仍存在操作技术不够规范、循证医学研究开展较少、 3D腹腔镜和机器人胃癌手术应用不够广泛等问题。因此，我们应该大力加强腹腔镜胃癌微创手术的规范化培训，深入开展腹腔镜胃癌手术的循证医学研究，积极推动3D腹腔镜和机器人胃癌手术的临床应用，进一步提高我国腹腔镜胃癌微创手术水平。

Laparoscopic gastrectomy is one of the main directions of minimally invasive surgery for gastric cancer. Since 1999, the first laparoscopic gastrectomy was reported, minimally invasive laparoscopic surgery for gastric cancer in China has undergone three stages： initial exploration period,rapid development period and gradual maturation period. The hospitals which performed laparoscopic gastrectomy and the reported cases have been increasing, at the same time the clinical efficacy is satisfied. However, there is still lack of standard and insufficient evidence in the treatment of gastric cancer by laparoscopic gastrectomy. The 3D laparoscopic and robotic gastrectomies still can not be performed in the most hospitals in China. So we should strengthen the standardization training of laparoscopic gastrectomy, develop the evidence- based medical research, promote the 3D laparoscopic and robotic gastrectomies to enhance the level of minimally invasive surgery for gastric cancer.