全腹腔镜胃癌根治术消化道重建技术与进展

Technology and development of digestive tract reconstruction in totally laparoscopic radical gastrectomy for gastric cancer

随着腹腔镜器械的进步及腹腔镜外科技术的发展,全腹腔镜下消化道重建技术在胃癌微创外科手术中的应用越来越广泛。在腹腔镜下完成胃周韧带组织的分离、淋巴结清扫和消化道的重建,降低了手术的创伤,减少对切口的依赖,尤其是对于肋弓较窄及肥胖症患者,其优势更为明显。但由于全腹腔镜胃癌手术操作难度大,技术要求高,应遵循消化道重建的基本原则,严格把握适应证和禁忌证,做好术中质量控制,推荐在已具备丰富腹腔镜胃癌手术经验的医疗中心开展。笔者查阅文献并结合团队临床实践加以论述,探讨全腹腔镜胃癌根治术消化道重建技术与进展。

With the development of laparoscopic instruments and surgery technology,the application of totally laparoscopic digestive tract reconstruction is more and more widely in the minimally invasive surgery of gastric cancer.Separation of gastric ligament tissue,dissection of lymph node,and digestive tract reconstruction under total laparoscopy can reduce surgical trauma and incisions.In particular for patients with rib arch narrow and obesity,totally laparoscopic radical gastrectomy for gastric cancer has more obvious advantages.However,due to difficult surgical operation and high technical requirements,totally laparoscopic gastrectomy for gastric cancer need strictly following the basic principles of digestive tract reconstruction,controlling the indications and contraindications,and evaluating intraoperative quality control,which is recommended to be carried out in medical centers with rich experience in laparoscopic gastric cancer surgery.The authors investigate technology and development of digestive tract reconstruction in totally laparoscopic radical gastrectomy for gastric cancer based on relevant literatures and their clinical practice.