腹腔镜探查在胃癌根治术应用技术要点及临床意义

The technical essential and clinical significance of laparoscopic exploration in radical gastrectomy for gastric cancer

近年来,随着胃癌诊疗技术和治疗策略转变,以新辅助化疗加术前免疫治疗、靶向治疗等术前综合治疗逐渐成为进展期胃癌常态化的治疗模式,其短期和长期的临床效果也得到广泛认可。准确的术前分期是通过多学科讨论、制定临床治疗方案和决策的前提,精准的术前分期依赖于影像学检查和腹腔镜探查,诊断性腹腔镜探查在辅助临床诊断和决策中扮演着重要角色。腹腔镜探查可以准确地判断胃癌腹膜转移和腹腔脱落细胞的情况,也可对胃癌的可切除性提供重要参考。因此,腹腔镜探查在进展期胃癌根治术中起着重要作用,为进展期胃癌的综合治疗提供了更准确的治疗选择。规范化的腹腔镜探查操作是获得准确术前分期的前提,腹腔镜探查在胃癌根治术中的临床意义和技术要点亦成为胃癌外科医师关注的焦点之一。

With the advancement of treatment techniques and strategies for gastric cancer,preoperative comprehensive therapy,represented by neoadjuvant chemotherapy(NACT)combined with preoperative immunotherapy,targeted therapy and so on,has gradually become the normalized treatment mode for advanced gastric cancer,and its short and long-term clinical outcomes have also been widely recognized.An accurate preoperative stage is the premise for therapeutic regimen and clinical decision-making by multidisciplinary discussion.The preoperative stage for gastric cancer mainly depends on imaging examination and laparoscopic exploration(LE),and the diagnostic laparoscopic exploration plays an important role in auxiliary diagnosis and decision-making.Laparoscopic exploration could accurately detect the peritoneal metastasis and exfoliated cancer cell in the abdominal cavity of gastric cancer,and provide an important reference for the resectability of gastric cancer.Therefore,laparoscopic exploration played an important role in radical gastrectomy of advanced gastric cancer,providing more exact treatment options for the comprehensive treatment of advanced gastric cancer.Normalized laparoscopic exploration is the prerequisite to obtaining an accurate preoperative stage and the clinical significance and technical points of laparoscopic exploration in radical gastrectomy of gastric cancer have also become a focus of gastric cancer surgeons.