Department of General Surgery and Surgical Specialties, Unit of General Surgery, Santa Maria Annunziata Hospital, Central Tuscany Local Health Company, Florence, Italy.
Department of General Surgery and Surgical Specialties, Unit of General Surgery, Santa Maria Annunziata Hospital, Central Tuscany Local Health Company, Florence, Italy.
Surg Oncol. 2022 Mar;40:101699. doi: 10.1016/j.suronc.2021.101699. Epub 2022 Jan 1.
Radical gastrectomy with an adequate lymphadenectomy is the main procedure which makes it possible to cure patients with resectable gastric cancer. A number of randomized controlled trials and meta-analysis provide phase III evidence that laparoscopic gastrectomy is technically safe and that it yields better short-term outcomes than conventional open gastrectomy for early-stage gastric cancer. At present, laparoscopic gastrectomy is considered a standard procedure for early-stage gastric cancer, especially in Asian countries. On the other hand, the use of minimally invasive techniques is still controversial for the treatment of more advanced tumours, principally due to existing concerns about its oncological adequacy and capacity to carry out an adequately extended lymphadenectomy. Additional high-quality studies comparing laparoscopic gastrectomy versus open gastrectomy for gastric cancer have been recently published, in particular concerning the latest results obtained by laparoscopic approach to advanced gastric cancer. It seems very useful to update the review of literature in light of these new evidences for this subject and draw some considerations.
根治性胃切除术加充分的淋巴结清扫术是可治愈可切除胃癌患者的主要方法。多项随机对照试验和荟萃分析提供了 III 期证据，表明腹腔镜胃切除术在技术上是安全的，并且对于早期胃癌，其短期疗效优于传统的开放性胃切除术。目前，腹腔镜胃切除术被认为是早期胃癌的标准手术方法，特别是在亚洲国家。另一方面，微创技术在治疗更晚期肿瘤方面的应用仍存在争议，主要是因为人们对其肿瘤学的充分性和进行充分扩大淋巴结清扫术的能力存在担忧。最近发表了一些比较腹腔镜胃切除术与开放性胃切除术治疗胃癌的高质量研究，特别是关于腹腔镜治疗进展期胃癌的最新结果。鉴于这些新证据，对这一主题进行文献综述更新并得出一些考虑是非常有用的。
