摘要
早期胃癌(EGC)的治疗近年来已从之前单纯追求肿瘤学的疗效向“提高生活质量与肿瘤学预后并重”的观念转变。腹腔镜保留功能的胃切除术(FPG)兼具“微创化”和“保功能”的优点,在日本和韩国受到广泛的关注并有大量相关研究。总体结果显示,腹腔镜FPG对EGC患者的肿瘤学疗效与腹腔镜下标准手术相当,而在手术的安全性、术后的营养状态及生活质量等方面均有积极作用。然而,腹腔镜下FPG也存在不足之处。例如,作为其代表术式之一,腹腔镜近端胃切除(LPG)术后胃食管反流等问题依然是限制其进一步应用的原因。随着适用于腹腔镜手术的新型抗反流重建方式的应用,患者LPG术后胃食管反流及反流性食管炎的发生率明显降低,生活质量明显改善。随着EGC患者比例的不断增加,腹腔镜FPG将进一步被广泛应用,对其适应证和不足的改进也是今后研究的重要方向。
The principle of treatments for early gastric cancer has shifted from“pursuing only the curative effect of oncology”in recent years to“improving the quality of life and the prognosis of oncology”.Laparoscopic function-preserving gastrectomy(FPG)has the advantages of both“minimally invasive”and“function-preserving”,which has received extensive attention in Japan and South Korea and a lot of research has been conducted.The overall results indicated that the oncological efficacy of laparoscopic FPG for EGC patients is equivalent to that of laparoscopic standardized surgery,and it has a positive effect on the safety of surgery,postoperative nutritional status and quality of life.At the same time,laparoscopic FPG also has shortcomings.For example,as one of its representative surgical procedures,problems such as gastroesophageal reflux after laparoscopic proximal gastrectomy(LPG)are still limiting its further application.In recent years,the application of some new anti-reflux reconstruction methods suitable for laparoscopic surgery has effectively reduced the occurrence of gastroesophageal reflux and reflux esophagitis after LPG.As the proportion of EGC continues to increase,laparoscopic FPG will be further widely used,and the improvement of its shortcomings is also an important direction for future research.
作者
束平
刘凤林
SHU Ping;LIU Fenglin(Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
出处
《中国肿瘤外科杂志》
CAS
2021年第5期421-425,共5页
Chinese Journal of Surgical Oncology
基金
国家自然科学基金(8217101827)
中山医院临床研究专项基金(2020ZSLC15)。
