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非暴露式内镜-腹腔镜联合手术治疗胃肿瘤：来自捷克共和国的首例经验

Non-Exposure Endoscopic-Laparoscopic Cooperative Surgery for Stomach Tumors: First Experience from the Czech Republic.

作者信息

Hajer Jan, Havlůj Lukáš, Whitley Adam, Gürlich Robert

机构信息

Second Department of Internal Medicine, Third Faculty of Medicine and University Hospital Královské Vinohrady, Charles University, Praha, Czech Republic.

Department of General Surgery, Third Faculty of Medicine and University Hospital Královské Vinohrady, Charles University, Praha, Czech Republic.

出版信息

Clin Endosc. 2018 Mar;51(2):167-173. doi: 10.5946/ce.2017.076. Epub 2018 Jan 4.

DOI:10.5946/ce.2017.076
PMID:29301064
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5903082/
Abstract

BACKGROUND/AIMS: The aim of this study was to investigate the use of non-exposure endoscopic wall-inversion surgery (NEWS) and the combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) in gastric tumors.

METHODS

We reviewed all cases of NEWS and CLEAN-NET performed in the department of surgery of the Royal Vinohrady Teaching Hospital.

RESULTS

Our department performed 12 gastric tumor resections (NEWS, =10 and CLEAN-NET, =2) between March 2016 and February 2017. The cases chosen for these resections included predominantly submucosal tumors with no signs of dissemination or local invasion and early gastric carcinomas (T1 and T1), where tumor location made it impossible to use endoscopic submucosal dissection. R0 resection margins were confirmed in all the cases.

CONCLUSIONS

NEWS and CLEAN-NET allow non-exposed full-thickness gastric wall resection in a way that uses a "close first, cut later" approach to prevent seeding of the peritoneal cavity with tumor cells. These mini-invasive techniques combine laparoscopic and endoscopic techniques, and preserve the full function of the stomach.

摘要

背景/目的：本研究旨在探讨非暴露式内镜壁翻转手术（NEWS）以及腹腔镜与内镜联合非暴露技术治疗胃肿瘤（CLEAN-NET）的应用情况。

方法

我们回顾了皇家维诺赫拉迪教学医院外科实施的所有NEWS和CLEAN-NET病例。

结果

2016年3月至2017年2月期间，我们科室共进行了12例胃肿瘤切除术（NEWS 10例，CLEAN-NET 2例）。这些切除病例主要包括无播散或局部侵犯迹象的黏膜下肿瘤以及早期胃癌（T1和T1期），肿瘤位置导致无法采用内镜黏膜下剥离术。所有病例均确认切缘为R0。

结论

NEWS和CLEAN-NET能够以“先闭合，后切割”的方式进行非暴露式全层胃壁切除，防止肿瘤细胞播散至腹腔。这些微创技术结合了腹腔镜和内镜技术，并保留了胃的全部功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c57e/5903082/06e16782e03a/ce-2017-076f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c57e/5903082/9cb8c31ed911/ce-2017-076f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c57e/5903082/922dee14fc01/ce-2017-076f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c57e/5903082/06e16782e03a/ce-2017-076f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c57e/5903082/9cb8c31ed911/ce-2017-076f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c57e/5903082/922dee14fc01/ce-2017-076f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c57e/5903082/06e16782e03a/ce-2017-076f3.jpg

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Combination of Laparoscopic and Endoscopic Approaches to Neoplasia with Non-exposure Technique (CLEAN-NET) for GIST with Ulceration.
早期胃癌的腹腔镜与内镜联合手术：实际应用前景
Front Oncol. 2022 Oct 3;12:969628. doi: 10.3389/fonc.2022.969628. eCollection 2022.
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Editors' Choice of Noteworthy Clinical Endoscopy Publications in the First Decade.编辑对第一个十年中值得关注的临床内镜出版物的选择。
Clin Endosc. 2021 Sep;54(5):633-640. doi: 10.5946/ce.2021.216. Epub 2021 Sep 13.
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