腹腔镜胃癌手术进展及展望

Progress and prospects of laparoscopic gastric cancer surgery

微创是外科手术发展的重要方向之一,腹腔镜胃癌根治术是目前应用最广泛的胃癌微创治疗技术。腹腔镜胃癌手术根据腹腔镜的种类可分为2D腹腔镜手术、3D腹腔镜手术、荧光腹腔镜手术以及机器人腹腔镜手术等。根据切除部位又分为腹腔镜根治性远端胃切除术、腹腔镜近端胃切除术、腹腔镜全胃切除术以及腹腔镜保留幽门的胃切除术等。肿瘤学的安全性是开展腹腔镜胃癌手术的关键,而腹腔镜下消化道重建是腹腔镜胃癌手术的难点。随着腹腔镜技术水平的逐步提高和临床研究证据的积累,腹腔镜胃癌手术势必会向更广的范围、更深的层次、更好的应用体验发展。

Minimally invasive surgery is one of the important directions in general surgery.Laparoscopic radical gastrectomy is currently the most widely used minimally invasive treatment for gastric cancer.According to the type of laparoscopic surgery,laparoscopic gastric cancer surgery can be divided into 2 D laparoscopic surgery,3 D laparoscopic surgery,fluorescent laparoscopic surgery and robotic laparoscopic surgery and so on.According to the resection sites,it can be divided into laparoscopic radical distal gastrectomy,laparoscopic proximal gastrectomy,laparoscopic total gastrectomy and laparoscopic pylorus-preserving gastrectomy.The safety of oncology is the key to laparoscopic surgery for gastric cancer,and laparoscopic gastrointestinal reconstruction is a difficult point in laparoscopic gastric cancer surgery.With the improving of laparoscopic technique and the accumulating of evidence of clinical trial,laparoscopic gastric cancer surgery will develop to a wider range,a deeper level and a better application experience.