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[胃癌的外科治疗:聚焦于集中化与腹腔镜切除术]

[Surgical treatment of gastric cancer: focus on centralisation and laparoscopic resections].

作者信息

Haverkamp Leonie, Ruurda Jelle P, van der Sluis Pieter C, van Hillegersberg Richard

机构信息

Universitair Medisch Centrum Utrecht, afd. Heelkunde, Utrecht, the Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2013;157(35):A5864.

Abstract

Approximately 2000 patients are diagnosed with gastric carcinoma in the Netherlands each year; about 500 will be eligible for curative surgical treatment. The 5-year survival rate after therapy aimed at curing the condition is 45%, which can increase by an average of 10% if perioperative chemotherapy is added to the treatment regimen. Surgical treatment consists of a distal or total gastrectomy with spleen-preserving lymphadenectomy. Centralising this type of treatment leads to less postoperative mortality and better oncological outcomes. There are indications that laparoscopic surgery can accelerate postoperative recovery time. There are insufficient long-term data on outcomes of laparoscopic surgery to date to be able to conclude whether the laparoscopic or open approach to total gastric resection is preferable.

摘要

在荷兰,每年约有2000例患者被诊断为胃癌;其中约500例适合接受根治性手术治疗。针对治愈该疾病的治疗后的5年生存率为45%,如果在治疗方案中加入围手术期化疗,平均可提高10%。手术治疗包括保留脾脏的远端或全胃切除术及淋巴结清扫术。将这类治疗集中进行可降低术后死亡率并改善肿瘤学结局。有迹象表明,腹腔镜手术可加快术后恢复时间。迄今为止,关于腹腔镜手术结局的长期数据不足,无法得出全胃切除的腹腔镜手术或开放手术哪种方法更优的结论。

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