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胃癌微创手术的现状:文献综述强调研究局限性。

Current status of minimally invasive surgery for gastric cancer: A literature review to highlight studies limits.

机构信息

Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy.

Department of Surgery, Division of Gastrointestinal Surgery, University of California, Irvine Medical Center, Orange, CA, USA.

出版信息

Int J Surg. 2015 May;17:34-40. doi: 10.1016/j.ijsu.2015.02.021. Epub 2015 Mar 7.

Abstract

BACKGROUND

Gastric cancer represents a great challenge for health care providers and requires a multidisciplinary approach in which surgery plays the main role. Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and more recently with the spread of robotic surgery, but a number of issues are currently being investigate, including the limitations in performing effective extended lymph node dissections and, in this context, the real advantages of using robotic systems, the possible role for advanced Gastric Cancer, the reproducibility of completely intracorporeal techniques and the oncological results achievable during follow-up.

METHOD

Searches of MEDLINE, Embase and Cochrane Central Register of Controlled Trials were performed to identify articles published until April 2014 which reported outcomes of surgical treatment for gastric cancer and that used minimally invasive surgical technology. Articles that deal with endoscopic technology were excluded.

RESULTS

A total of 362 articles were evaluated. After the review process, data in 115 articles were analyzed.

CONCLUSION

A multicenter study with a large number of patients is now needed to further investigate the safety and efficacy as well as long-term outcomes of robotic surgery, traditional laparoscopy and the open approach.

摘要

背景

胃癌是医疗保健提供者面临的巨大挑战,需要采用多学科方法,其中手术发挥主要作用。微创手术得到了逐步发展,最初是腹腔镜技术的出现,最近则是机器人手术的普及,但目前仍有许多问题需要研究,包括进行有效扩大淋巴结清扫术的局限性,以及在这种情况下,机器人系统的实际优势、先进胃癌的可能作用、完全腔内置入技术的可重复性以及在随访期间可实现的肿瘤学结果。

方法

检索 MEDLINE、Embase 和 Cochrane 对照试验中心注册库,以确定截至 2014 年 4 月报告胃癌手术治疗结果且使用微创外科技术的文章。排除涉及内镜技术的文章。

结果

共评估了 362 篇文章。经过审查程序,分析了 115 篇文章中的数据。

结论

现在需要进行一项多中心、大样本量的研究,以进一步调查机器人手术、传统腹腔镜手术和开放手术的安全性、有效性以及长期结果。

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