早期胃癌不断变化的内镜治疗：昨天—今天—明天。
Ever-changing endoscopic treatment for early gastric cancer: yesterday-today-tomorrow.
作者信息
Kim Mi-Young, Cho Jun-Hyung, Cho Joo Young
机构信息
Mi-Young Kim, Jun-Hyung Cho, Joo Young Cho, Digestive Disease Center, Soonchunhyang University Hospital, Seoul 140-887, South Korea.
出版信息
World J Gastroenterol. 2014 Oct 7;20(37):13273-83. doi: 10.3748/wjg.v20.i37.13273.
Abstract
Endoscopic resection has been an optimal treatment for selected patients with early gastric cancer (EGC) based on advances in endoscopic instruments and techniques. As endoscopic submucosal dissection (ESD) has been widely used for treatment of EGC along with expanding ESD indication, concerns have been asked to achieve curative resection for EGC while guaranteeing precise prediction of lymph node metastasis (LNM). Recently, new techniques including ESD or endoscopic full-thickness resection combined with sentinel node navigation enable minimal tumor resection and a laparoscopic lymphadenectomy in cases of EGC with high risk of LNM. This review covers the development and challenges of endoscopic treatment for EGC. Moreover, a new microscopic imaging and endoscopic techniques for precise endoscopic diagnosis and minimally invasive treatment of EGC are introduced.
摘要
基于内镜器械和技术的进步，内镜切除术一直是部分早期胃癌（EGC）患者的最佳治疗方法。随着内镜黏膜下剥离术（ESD）的广泛应用以及ESD适应证的不断扩大，人们开始关注如何在确保精确预测淋巴结转移（LNM）的同时，实现EGC的根治性切除。近年来，包括ESD或内镜全层切除术联合前哨淋巴结导航在内的新技术，能够在LNM风险较高的EGC病例中实现最小化肿瘤切除和腹腔镜淋巴结清扫术。本文综述了EGC内镜治疗的发展与挑战。此外，还介绍了用于EGC精确内镜诊断和微创治疗的新型显微成像和内镜技术。
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