晚期胃癌联合器官切除手术指征分析

Indications analysis for multiorgan resection in advanced gastric cancer

晚期胃癌包括远处转移和局部晚期,其常涉及的转移器官包括肝脏、横结肠、胰腺和卵巢等,是否行联合器官切除备受争议。由于联合器官切除手术难度较大,术后并发症发生风险高,由此可能抵消手术切除带来的生存获益,故须严格把握手术指征。手术决策的制定须依据准确的术前影像学检查,并经过充分的多学科综合治疗协作组(MDT)讨论。强化围手术期管理,严格把握手术适应证,审慎选择合适病人,并精细手术操作,才能更好地改善病人预后。

Advanced gastric cancer included metastastic cases and locally advanced cases. The cases are more likely to invade liver, transverse colon and ovary. Multiorgan resection is controversial. Because the difficulty of multiorgan resection and high-risk of postoperative complications after surgery may offset the survival benefit for patients, indications for muhiorgan resection should be emphasized. Decision of surgical strategy depends on the accurate preoperative image examination and thorough muhidisciplinary team discussion. Strengthening perioperative management with appropriate patient selection and meticulous operative procedure can improve patient＇ s prognosis.