胃癌微创外科临床研究进展及展望（2000-2020)

Advance and prospect of clinical research on minimally invasive surgery for gastric cancer(the year of 2000 to 2020)

目前临床研究已证实腹腔镜胃癌根治术治疗早期胃癌的安全性、可行性和有效性。基于此,第4版日本《胃癌治疗指南》推荐腹腔镜手术治疗临床Ⅰ期远端胃癌。然而,腹腔镜胃癌手术治疗进展期胃癌的有效性和安全性仍存争议。中国腹腔镜胃肠外科研究组(CLASS研究组)发起的CLASS-01研究顺利完成,提供了全球首个局部进展期胃癌腹腔镜手术安全性和疗效的前瞻性多中心证据。胃癌外科的主流方向在从"大切口和扩大化手术切除"逐渐向"微创、精准化手术"转变,以使手术安全性和病人术后生活质量最优化。

A number of clinical evidence has confirmed the safety and effectiveness of laparoscopic gastrectomy for early gastric cancer.Based on the evidence,the Japanese gastric cancer treatment guideline recommends laparoscopic surgery is an option for the treatment of clinical stage I distal gastric cancer.However,the effectiveness and safety of laparoscopic gastrectomy for advanced gastric cancer remains controversial.The CLASS-01 trial initiated by the Chinese Laparoscopic Gastrointestinal Surgery Group(CLASS Group)was successfully completed,providing the world’s first prospective multicenter evidence of the safety and efficacy of laparoscopic surgery for locally advanced gastric cancer.The mainstream direction of gastric cancer surgery is gradually changing from"large incision and enlarged surgical resection"to"minimally invasive and precise surgery"in order to optimize the safety of surgery and the quality of life of patients postoperatively.