新辅助化疗后胃癌手术并发症的特点及影响因素研究进展

Characteristics and Risk Factors of Postoperative Complications in Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy

尽管医疗器械在不断发展及胃切除+D2淋巴结清扫术式逐步标准化,进展期胃癌仍有较高的远处转移率和局部复发率,预后较差。新辅助化疗以降低肿瘤分期、提高手术R0切除率及消灭潜在微转移灶等优势显著改善进展期胃癌患者的长期生存,但术前化疗的不良反应是否会提高术后并发症的发生率仍是人们所关心的重点,术后并发症可通过其相关的炎性反应变化激活微小残留病变和促进转移或延迟辅助治疗而影响肿瘤学预后,因此新辅助化疗广泛应用的前提应是对手术安全性的保证。本文就新辅助化疗后手术并发症的发生率、严重程度及预后等方面进行综述并进一步探讨其影响因素。

Despite the continuous development of medical devices and the standardization of gastrectomy plus D2 lymph node dissection,advanced gastric cancer still has high distant metastasis rate and local recurrence rate,and the prognosis is poor.Neoadjuvant chemotherapy can improve the long-term survival of patients with advanced gastric cancer by reducing tumor stage,increasing R0 resection rate and eliminating potential micrometastasis.However,it is still the focus of concern that whether the adverse reactions of preoperative chemotherapy will increase the incidence of postoperative complications.Postoperative complications can affect the oncological outcomes by activating minimal residual lesions and promoting metastasis through related inflammatory changes or delaying adjuvant therapy,so the premise of wide application of neoadjuvant chemotherapy should be the guarantee of surgical safety.This article reviews the incidence,severity and prognosis of operative complications in gastric cancer patients after neoadjuvant chemotherapy and further explores its influencing factors.