Berlth Felix, Knospe Luise, Jansen-Winkeln Boris, Hadzijusufovic Edin, Tagkalos Evangelos, Niebisch Stefan, Moulla Yusef, Chalopin Claire, Köhler Hannes, Maktabi Marianne, Lang Hauke, Grimminger Peter, Gockel Ines
Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55133, Mainz, Deutschland.
Klinik und Poliklinik für Viszeral‑, Transplantations‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
Chirurg. 2021 Jun;92(6):528-534. doi: 10.1007/s00104-021-01391-z. Epub 2021 Mar 24.
The surgical treatment of gastric cancer has arrived at a turning point towards the routine application of minimally invasive techniques. After the first results of prospective randomized trials from Asia confirmed the surgical and oncological safety, the latest results of international trials provided evidence for minimally invasive gastrectomy of advanced gastric cancer in a multimodal setting. A new addition in the field of minimally invasive procedures is robotic-assisted surgical techniques, which have already been implemented for these indications in many centers in Germany. The technical advantages that are applicable in the robotics setting in comparison to laparoscopy lead to a rapid dissemination of the procedure but still need to be evaluated in controlled trials. Further developments for the surgical treatment of gastric cancer are found in the field of intraoperative imaging procedures. In this field various technologies are available, such as fluorescence imaging using a near-infrared camera, which requires the use of a fluorescent agent or the hyperspectral camera system, which does not require the application of a fluorophore and merges pictures from visible and non-visible wavelengths to a functional image. It is to be expected that in the future various technological advancements can make a valuable contribution to the surgical treatment of gastric cancer in the clinical routine, especially if they support and facilitate the use of minimally invasive surgical techniques.
胃癌的外科治疗已朝着微创技术的常规应用迈进至转折点。亚洲前瞻性随机试验的首批结果证实了手术及肿瘤学安全性后，国际试验的最新结果为晚期胃癌在多模式治疗中的微创胃切除术提供了证据。微创操作领域的一项新进展是机器人辅助手术技术，德国许多中心已针对这些适应症采用了该技术。与腹腔镜检查相比，机器人手术设置中适用的技术优势促使该手术迅速普及，但仍需在对照试验中进行评估。胃癌外科治疗的进一步发展体现在术中成像程序领域。在该领域有多种技术可供使用，例如使用近红外相机的荧光成像，这需要使用荧光剂；或者超光谱相机系统，该系统无需应用荧光团，而是将来自可见和不可见波长的图像合并为功能图像。预计未来各种技术进步可为临床常规胃癌外科治疗做出宝贵贡献，特别是当它们支持并促进微创外科技术的使用时。
