Wang Shuchang, Yu Site, Xu Jia, Zhao Gang
Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Oct 25;20(10):1141-1144.
Preserving gastric function and improving quality of life (QOL) is the tendency of surgery for early gastric cancer. Function preserving gastrectomy (FPG) is applied to modify the extent of surgery and to achieve better quality of life at the premise of radical resection. Pylorus-preserving gastrectomy is the most favorable approach of FPG with oncological safety, which can improve nutritional status and QOL via preserving pylorus and vagal nerve. Proximal gastrectomy is widely accepted as FPG for early upper 1/3 gastric cancer. However, the most optimal way of anastomosis is not yet solved. Sentinel node navigation is currently the most accurate approach for intraoperative diagnosis of lymph node metastasis, which stimulates the development of many kinds of FPG procedures for individual treatment. Nevertheless, more efforts should be made to reduce false negative rate of sentinel node biopsy. Herein we discuss the valuation and prospect of FPG.
保留胃功能并改善生活质量(QOL)是早期胃癌手术的趋势。功能保留性胃切除术(FPG)用于调整手术范围,并在根治性切除的前提下实现更好的生活质量。保留幽门胃切除术是FPG中最有利的方法,具有肿瘤学安全性,可通过保留幽门和迷走神经来改善营养状况和生活质量。近端胃切除术被广泛认为是早期胃上1/3癌的FPG。然而,最优化的吻合方式尚未解决。前哨淋巴结导航是目前术中诊断淋巴结转移最准确的方法,它推动了多种个体化治疗的FPG手术的发展。尽管如此,仍应做出更多努力以降低前哨淋巴结活检的假阴性率。在此我们讨论FPG的评估和前景。