胃癌微创外科的研究与技术进展

Progress of research and technical in minimally invasive surgery for gastric cancer

胃癌是世界范围内常见的恶性肿瘤之一,其发病率和死亡率均位于我国恶性肿瘤前列。自1992年Kitano等完成世界第1例腹腔镜胃癌根治术以来,腹腔镜技术得到快速发展。经过30余年的探索与实践,我国胃癌临床诊断与治疗亦取得长足进步。国内外大量临床研究均证实腹腔镜胃癌根治术具有不亚于传统开腹手术近远期疗效。腹腔镜胃癌根治术具有创伤性小、术后胃肠功能恢复快、术后疼痛轻、平均住院时间短等特点,逐步取代开腹手术,成为胃癌外科的主流手术方式。随着胃癌手术治疗理念持续更新,新兴微创技术不断涌现,其中机器人手术系统和吲哚菁绿示踪技术等在胃癌手术中的应用与日俱增,使胃癌外科更加微创、精准,并提高胃周淋巴结清扫质量,国内胃癌外科技术进一步精进。笔者结合国内外相关研究,以胃癌微创外科技术为主题,回顾归纳近年来最新进展,旨在系统阐述胃癌外科的现状和未来展望。相信未来,我国的胃癌临床诊断与治疗必将更为规范化、微创化、精准化,必将开展更多高质量的多中心临床研究和进一步深化胃癌诊断与治疗规范。

Gastric cancer is one of the most common malignant tumors in the world,and its incidence and mortality are among the top of malignant tumors in China.Since Kitano et al com-plete the first laparoscopic radical gastrectomy for gastric cancer in the world in 1992,the laparos-copic technology has developed rapidly.After more than 30 years of exploration and practice,the clinical diagnosis and treatment of gastric cancer in China has also made considerable progress.A large number of clinical studies at home and abroad have confirmed that laparoscopic radical gas-trectomy is no less effective than traditional open surgery in the short and long term.Laparoscopic radical gastrectomy has the characteristics of less trauma,faster recovery of gastrointestinal func-tion,less postoperative pain,and shorter average hospital stay.It has gradually replaced open surgery as the mainstream surgical method for gastric cancer.As the concept of surgical treatment for gastric cancer continues to update,emerging minimally invasive technologies continue to emerge,including robotic surgery systems and indocyanine green tracing technology,which are increasingly used in gastric cancer surgery,making gastric cancer surgery more minimally invasive and accurate,the quality of perigastric lymph node dissection and the domestic gastric cancer surgery technology further improving.Based on the relevant research at home and abroad,the authors review and summarize the latest progress in recent years with the topic of minimally invasive surgery for gastric cancer,aiming to systematically describe the current situation and future prospects of gastric cancer surgery.It is believed that in the future,the clinical diagnosis and treatment of gastric cancer in China will be more standardized,minimally invasive and accurate,more high-quality multicenter clinical research will be carry out and the diagnosis and treatment of gastric cancer will be further improved in China.