Chen Xin-Zu, Zhang Wei-Han, Hu Jian-Kun
Xin-Zu Chen, Wei-Han Zhang, Jian-Kun Hu, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2014 Nov 28;20(44):16793-4. doi: 10.3748/wjg.v20.i44.16793.
There is no robust evidence to define a safe proximal margin by distance for early gastric cancer (EGC). The discussion on resection margin should not only focus on the oncologic safety, but also the postgastrectomy quality of life. The distance 1-10 mm is only acceptable for those endoscopic treatment fit EGC patients. For endoscopic unfit EGC cases, if the borderline of tumor is able to be clearly determined intraoperatively, the distance 1-3 cm is recommended for proximal resection margin. If there is any uncertainty on the tumor borderline, the distance 3-5 cm should be considered for proximal margin.
目前尚无确凿证据能通过距离来定义早期胃癌(EGC)安全的近端切缘。关于切缘的讨论不应仅关注肿瘤学安全性,还应考虑胃切除术后的生活质量。对于适合内镜治疗的EGC患者,1 - 10毫米的距离是可以接受的。对于不适合内镜治疗的EGC病例,如果术中能够清晰确定肿瘤边界,近端切缘建议距离为1 - 3厘米。如果肿瘤边界存在任何不确定性,则近端切缘应考虑距离为3 - 5厘米。