Niimi Keiko, Ishibashi Rei, Mitsui Takashi, Aikou Susumu, Kodashima Shinya, Yamashita Hiroharu, Yamamichi Nobutake, Hirata Yoshihiro, Fujishiro Mitsuhiro, Seto Yasuyuki, Koike Kazuhiko
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Center for Epidemiology and Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Ann Transl Med. 2017 Apr;5(8):187. doi: 10.21037/atm.2017.03.35.
With technological progress of endoscopic submucosal dissection (ESD) in the last decade, several laparoscopic and endoscopic cooperative surgeries (LECS) for gastrointestinal tumor have recently been developed. LECS is definitely favorable to the minimization of surgical margin, which leads to functional and anatomical preservation of gastrointestinal tract. LECS for gastrointestinal tumor is mainly sorted by two categories: exposure procedures and non-exposure procedures between endoluminal and extraluminal spaces. Exposure procedures have the potential risk of gastric contents or tumor cells spilling out over the abdominal cavity, because the stomach wall has to be perforated intentionally during the procedure. In order to avoid the potential these risks, non-exposure procedures have been developed. Currently, the LECS concept has rapidly permeated for treatment of gastrointestinal tumor due to its certainty and safety, although there is still room for improvement to lessen its technical difficulty. This review describes the current LECS for gastrointestinal tumor based on the several articles.
随着过去十年内镜下黏膜剥离术（ESD）技术的进步，近年来已开发出几种用于胃肠道肿瘤的腹腔镜与内镜联合手术（LECS）。LECS对于将手术切缘最小化肯定是有利的，这有助于胃肠道的功能和解剖结构保留。胃肠道肿瘤的LECS主要分为两类：腔内与腔外空间之间的暴露手术和非暴露手术。暴露手术存在胃内容物或肿瘤细胞溢出至腹腔的潜在风险，因为在手术过程中必须有意穿透胃壁。为了避免这些潜在风险，已开发出非暴露手术。目前，LECS概念因其确定性和安全性已迅速渗透到胃肠道肿瘤的治疗中，尽管在降低其技术难度方面仍有改进空间。本综述基于几篇文章描述了当前用于胃肠道肿瘤的LECS。
