Sajid Muhammad Shafique, Hebbar Madhusoodhana, Sayegh Mazin E
Department of Gastrointestinal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Department of General and Laparoscopic Surgery, Western Sussex Hospitals Foundation NHS Trust, Worthing Hospital, Worthing, UK.
Transl Gastroenterol Hepatol. 2017 May 9;2:44. doi: 10.21037/tgh.2017.04.06. eCollection 2017.
The aim of this study is to review the literature and report the various minimally invasive methods used to treat gastric cancer in the UK and compare it with worldwide practice. Published randomised studies, non-randomised studies and case series reporting the use of minimal invasive approach to treat gastric cancer were retrieved from the search of standard medical electronic databases and their outcomes were highlighted suggesting their effectiveness. Several randomised, controlled trials and meta-analyses have proven the clinical and oncological safety of the laparoscopic gastrectomy for gastric cancer. Similarly, robot-assisted gastrectomy, EMR (endoscopic mucosal resection) and ESD (endoscopic sub-mucosal dissection) have also been proven feasible and safe to treat gastric cancer of various stages in prospective and retrospective comparative studies. However, UK based studies on minimally invasive surgery to treat gastric cancer is scarce and the paucity of trials led to uncertain outcomes. Laparoscopic gastrectomy, robot-assisted gastrectomy, EMR and ESD are feasible procedures in terms of clinical and oncological safety but mainly being practiced in Asian countries with high prevalence of stomach cancer. The UK based practice is still small and limited but the introduction of MIGOCS and STOMACH trial might help to widen the application of this technique.
本研究的目的是回顾文献，报告英国用于治疗胃癌的各种微创方法，并将其与全球实践进行比较。通过检索标准医学电子数据库，获取已发表的关于使用微创方法治疗胃癌的随机研究、非随机研究和病例系列，并突出显示其结果以表明其有效性。多项随机对照试验和荟萃分析已证明腹腔镜胃癌切除术在临床和肿瘤学方面的安全性。同样，在前瞻性和回顾性比较研究中，机器人辅助胃癌切除术、内镜黏膜切除术（EMR）和内镜黏膜下剥离术（ESD）也已被证明在治疗各阶段胃癌方面是可行且安全的。然而，英国关于微创外科治疗胃癌的研究很少，试验的匮乏导致结果不确定。腹腔镜胃癌切除术、机器人辅助胃癌切除术、EMR和ESD在临床和肿瘤学安全性方面是可行的手术，但主要在胃癌高发的亚洲国家开展。英国的实践规模仍然较小且有限，但引入MIGOCS和STOMACH试验可能有助于扩大这项技术的应用。
