腹腔镜胃癌根治术的现况及循证医学证据

Laparoscopic gastrectomy for gastric cancer: current considerations and evidence-based complementary

腹腔镜手术是近年来我国胃肠外科发展的主要方向。针对胃部恶性肿瘤,腹腔镜不但可对癌变组织进行完整切除,还能对胃周淋巴结进行有效的清扫,具有视野清晰、手术创伤小和术后恢复快等优点,其应用范围及适应证也不断扩大。本文简述腹腔镜外科治疗胃癌的原则、术式,并结合循证医学的证据,总结腔镜下不同手术方式的安全性及治疗效果。同时,评价腔镜下对不同临床分期的胃癌需清扫淋巴结的范围及数量,探讨其肿瘤学根治的可靠性,为临床医师提供一定的理论参考。

Recent years, laparoscopic techniques has been widely established in our country. For gastric cancer, laparoscopic surgery can not only removal the cancerous tissue, but also dissect adequate lymph nodes, with a clear vision, less trauma and quick recovery advantages, which expands its indication and applicable scope. In this article, we summarize the principle of laparoscopic gas仕ectomy,combining with evidence-based research,to flirther discuss the clinical outcomes of different laparoscopic procedures. In the same time, our paper also report the technical difficulty of carrying out lymphadenectomy and oncological adequacy for different stage of stomach cancer. We believe this work can provide a certain theoretical proofs for clinical work.