围手术期肌少症和超重/肥胖型胃癌患者运动方案的临床影响
Clinical Impact of a Perioperative Exercise Program for Sarcopenia and Overweight/Obesity Gastric Cancer.
机构信息
Department of Surgery, Yokohama City University, Yokohama, Japan;
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
出版信息
In Vivo. 2021 Mar-Apr;35(2):707-712. doi: 10.21873/invivo.12311.
Gastrectomy with D2 lymph node dissection and perioperative adjuvant treatment is the standard treatment for locally advanced gastric cancer. However, the morality rate is reported to be 20%-40% after gastrectomy for gastric cancer. Perioperative sarcopenia and obesity are strongly related to postoperative surgical complications after gastrectomy. Furthermore, recent studies have shown that postoperative surgical complications are related to long-term oncological outcomes. If we can prevent or improve perioperative sarcopenia or obesity in gastric cancer patients, the rate of postoperative surgical complications in these patients might be reduced, thereby improving the long-term oncological outcomes. Given this hypothesis, recent studies have focused on enacting perioperative exercise programs for gastric cancer patients with sarcopenia and overweight/obesity. Such exercise programs have proven promising and demonstrated some clinical benefits for gastric cancer patients with sarcopenia and overweight/obesity. However, whether or not perioperative exercise programs have clinical benefits with regard to long-term oncological outcomes in gastric cancer patients is unclear. To optimize these perioperative exercise programs for gastric cancer patients, it is necessary to clarify the benefits with regard to the long-term oncological outcomes in these patients and establish an optimal perioperative exercise program.
胃切除术联合 D2 淋巴结清扫术和围手术期辅助治疗是局部进展期胃癌的标准治疗方法。然而，胃癌胃切除术后的死亡率据报道为 20%-40%。围手术期肌少症和肥胖与胃切除术后的手术并发症密切相关。此外，最近的研究表明，术后手术并发症与长期肿瘤学结果相关。如果我们能够预防或改善胃癌患者的围手术期肌少症或肥胖，这些患者的术后手术并发症发生率可能会降低，从而改善长期肿瘤学结果。基于这一假设，最近的研究集中在为肌少症和超重/肥胖的胃癌患者制定围手术期运动方案。这些运动方案已被证明是有前途的，并为肌少症和超重/肥胖的胃癌患者带来了一些临床获益。然而，围手术期运动方案是否对胃癌患者的长期肿瘤学结果具有临床获益尚不清楚。为了优化这些针对胃癌患者的围手术期运动方案，有必要明确这些方案对患者长期肿瘤学结果的获益，并制定出最佳的围手术期运动方案。
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