Son Taeil, Hyung Woo Jin
Taeil Son, Woo Jin Hyung, Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, South Korea.
World J Gastroenterol. 2016 Jan 14;22(2):727-35. doi: 10.3748/wjg.v22.i2.727.
Laparoscopic gastrectomy has been widely accepted as a standard alternative for the treatment of early-stage gastric adenocarcinoma because of its favorable short-term outcomes. Although controversies exist, such as establishing clear indications, proper preoperative staging, and oncologic safety, experienced surgeons and institutions have applied this approach, along with various types of function-preserving surgery, for the treatment of advanced gastric cancer. With technical advancement and the advent of state-of-the-art instruments, indications for laparoscopic gastrectomy are expected to expand as far as locally advanced gastric cancer. Laparoscopic gastrectomy appears to be promising; however, scientific evidence necessary to generalize this approach to a standard treatment for all relevant patients and care providers remains to be gathered. Several multicenter, prospective randomized trials in high-incidence countries are ongoing, and results from these trials will highlight the short- and long-term outcomes of the approach. In this review, we describe up-to-date findings and critical issues regarding laparoscopic gastrectomy for gastric cancer.
由于其良好的短期疗效,腹腔镜胃切除术已被广泛接受为早期胃腺癌治疗的标准替代方法。尽管存在一些争议,如明确适应证、恰当的术前分期和肿瘤学安全性等,但经验丰富的外科医生和机构已将这种方法与各种类型的保留功能手术一起应用于晚期胃癌的治疗。随着技术的进步和先进仪器的出现,腹腔镜胃切除术的适应证有望扩展至局部晚期胃癌。腹腔镜胃切除术似乎很有前景;然而,将这种方法推广至所有相关患者和医疗服务提供者的标准治疗所需的科学证据仍有待收集。高发病率国家正在进行几项多中心、前瞻性随机试验,这些试验的结果将突出该方法的短期和长期疗效。在本综述中,我们描述了关于腹腔镜胃癌切除术的最新研究结果和关键问题。