Hiramatsu Yoshihiro, Kikuchi Hirotoshi, Takeuchi Hiroya
Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan.
Department of Perioperative Functioning Care and Support, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan.
Cancers (Basel). 2021 Dec 10;13(24):6223. doi: 10.3390/cancers13246223.
Recently, minimally invasive (endoscopic or laparoscopic) treatment for early gastric cancer (EGC) has been widely accepted. However, a standard gastrectomy with radical lymphadenectomy is generally performed in patients with EGC who have no indications for endoscopic resection, and postgastrectomy dysfunction is one of the problems of standard gastrectomy. Function-preserving gastrectomy, such as proximal gastrectomy and pylorus-preserving gastrectomy, can be considered when attempting to preserve the patient's quality of life (QOL) postoperatively. In addition, sentinel node navigation surgery for EGC has been applied in clinical practice in several prospective studies on function-preserving personalized minimized gastrectomy. In the near future, the sentinel lymph node concept is expected to form the basis for establishing an ideal, personalized, minimally invasive function-preserving treatment for patients with EGC, which will improve their postoperative QOL without compromising their long-term survival. In this review article, we summarize the current status, surgical techniques, and postoperative outcomes of function-preserving gastrectomy for EGC.
最近,早期胃癌(EGC)的微创(内镜或腹腔镜)治疗已被广泛接受。然而,对于没有内镜切除指征的EGC患者,通常会进行标准胃切除术并进行根治性淋巴结清扫,而胃切除术后功能障碍是标准胃切除术的问题之一。当试图保留患者术后的生活质量(QOL)时,可以考虑保留功能的胃切除术,如近端胃切除术和保留幽门的胃切除术。此外,EGC的前哨淋巴结导航手术已在几项关于保留功能的个性化最小化胃切除术的前瞻性研究中应用于临床实践。在不久的将来,前哨淋巴结概念有望成为为EGC患者建立理想的、个性化的、微创保留功能治疗的基础,这将在不影响其长期生存的情况下改善他们的术后QOL。在这篇综述文章中,我们总结了EGC保留功能胃切除术的现状、手术技术和术后结果。