Etoh Tsuyoshi, Shiroshita Hidefumi, Shiraishi Norio, Kitano Seigo, Inomata Masafumi
Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.
Center for Community Medicine, Oita University Faculty of Medicine, Oita, Japan.
Transl Gastroenterol Hepatol. 2016 Apr 11;1:31. doi: 10.21037/tgh.2016.03.15. eCollection 2016.
Since the development of laparoscopy-assisted distal gastrectomy (LADG) with lymph node dissection for gastric cancer in Japan, this type of surgery is improving and evolving. To establish high-quality evidence of laparoscopic gastrectomy (LAG) in the field of gastric cancer treatments, two large-scale, prospective randomized controlled trials have been performed in Japan; the Japan Clinical Oncology Study Group (JCOG) 0912 for early disease and the Japanese Laparoscopic Surgery Study Group (JLSSG) 0901 for advanced disease. Analyses using mega-data from the National Clinical Database (NCD) have also been carried out as a clinical study to clarify the safety of LAG. Furthermore, as advanced laparoscopic techniques have been developed, prospective clinical studies are being performed with regard to laparoscopy-assisted total gastrectomy (LATG), robotic gastrectomy, and minimally invasive surgery with sentinel node (SN) navigation. This review summarizes the current status of minimally invasive surgeries for gastric cancer based on the latest ongoing clinical trials in Japan.
自从日本开展腹腔镜辅助远端胃癌切除术（LADG）并进行淋巴结清扫以来，这类手术一直在改进和发展。为了在胃癌治疗领域建立腹腔镜胃切除术（LAG）的高质量证据，日本进行了两项大规模、前瞻性随机对照试验；针对早期疾病的日本临床肿瘤学研究组（JCOG）0912试验和针对晚期疾病的日本腹腔镜手术研究组（JLSSG）0901试验。作为一项临床研究，还利用国家临床数据库（NCD）的大数据进行了分析，以阐明LAG的安全性。此外，随着先进腹腔镜技术的发展，正在针对腹腔镜辅助全胃切除术（LATG）、机器人胃切除术以及前哨淋巴结（SN）导航的微创手术开展前瞻性临床研究。本综述基于日本目前正在进行的最新临床试验，总结了胃癌微创手术的现状。
