Zhao Enhao, Zhao Gang, Cao Hui
Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200127, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2018 Feb 25;21(2):132-137.
In the past few years, the early detection of gastric cancer has increased in China. The surgical treatment for early gastric cancer has gradually transformed from conventional gastrectomy with D2 lymphadenectomy to function-preserving gastrectomy which maximally preserves the anatomy and physiology of stomach to maintain the quality of life of the patient. Driven by minimally invasive techniques, function-preserving gastrectomies, including pylorus-preserving gastrectomy, proximal gastrectomy, sentinel node navigation surgery, etc. have already gained great attention especially in Japan and Korea. Although there are still many unsolved problems that need to be further discussed and explored, understanding of the clinical features of early gastric cancer and definition of gastric function preservation, launching clinical trials for solving practical problems, and emphasis of individualized and precision treatment will be the best strategies to improve the efficacy of early gastric cancer.
在过去几年中,中国早期胃癌的检出率有所上升。早期胃癌的外科治疗已逐渐从传统的D2淋巴结清扫胃切除术转变为保留功能的胃切除术,这种手术最大限度地保留了胃的解剖结构和生理功能,以维持患者的生活质量。在微创技术的推动下,保留功能的胃切除术,包括保留幽门胃切除术、近端胃切除术、前哨淋巴结导航手术等,尤其在日本和韩国已经受到了极大关注。尽管仍有许多未解决的问题需要进一步讨论和探索,但了解早期胃癌的临床特征以及胃功能保留的定义、开展解决实际问题的临床试验,以及强调个体化和精准治疗,将是提高早期胃癌疗效的最佳策略。