腹腔镜和内镜联合手术在早期胃癌治疗中应用价值

The value of laparoscopic and endoscopic combined surgery in the treatment of early gastric cancer

早期胃癌的手术治疗正由追求传统和标准化转向微创化、精准化和个体化发展,即从单纯强调根治转变为根治与保留功能并重。腹腔镜和内镜联合手术(LECS)是其中的重要实践,该术式既可对内镜治疗下难以处理的早期胃癌病灶进行局部精准切除,又能够对潜在的转移淋巴结进行清扫。尽管目前暂无更多大型临床试验验证此类术式的有效性和安全性,但经过近20年的实践,已证明LECS是一种具有临床可操作性并能提高病人获益的治疗手段,LECS+前哨淋巴结导航手术将是未来早期胃癌治疗的重要发展方向。

The surgical treatment of early gastric cancer(EGC) is shifting from the pursuit of tradition and standardization to minimally invasive, precise, and individualized development. The concept is changing from a simple emphasis on radical treatment to giving consideration to both radical treatment and functional preservation.Laparoscopic and endoscopic combined surgery(LECS) is an important practice among them, which can not only perform local precise resection of early gastric cancer lesions that are difficult to treat under endoscopic therapy, but also dissect potential metastatic lymph nodes. Although there are no more large-scale clinical trials to verify the efficacy and safety of this surgery, after nearly 20 years of practice, LECS has been proven to be a clinically operable treatment that can improve patient benefits. LECS and sentinel lymph node navigation surgery will be an important development direction for the treatment of early gastric cancer in the future.