Lin C, Zhang Z Z, Wang L
Department of General Surgery,Fuzong Clinical Medical College Affiliated to Fujian Medical University(the 900th Hospital of the Joint Logistics Support Force of Chinese PLA), Fuzhou 350025, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2023 Aug 25;26(8):798-802. doi: 10.3760/cma.j.cn441530-20230504-00144.
With the introduction of minimally invasive methods into the field of surgery, the concept of early gastric cancer (EGC) treating has gradually changed from the pursuit of standardized traditional surgical methods to precise, individualized, interdisciplinary collaborative management. Both endoscopic therapy and laparoscopic surgery have their limitations for early gastric cancer treatment. Meanwhile, Laparoscopic and endoscopic cooperative surgery (LECS) combines the advantages of endoscopy and laparoscopy to perform local gastric resection and regional lymph node dissection, providing a more effective surgical approach for radical resection of early gastric cancer. The application of LECS in the treatment of early gastric cancer has been increasing, from the initial laparoscopy-assisted endoscopic full-thickness resection to the evolvement of a variety of improved procedures such as combined laparoscopic and endoscopic approach for neoplasia with a non-exposure technique, non-exposed endoscopic wall-inversion surgery, and the possibility of combined (sentinel lymph node drainage area) regional lymph node dissection or sentinel lymph node navigation surgery, which expands the indications for endoscopic surgery and maximizes the preservation of normal gastric tissue structure and function while ensuring radical treatment, and will certainly become an important development direction in the treatment of early gastric cancer in the future.
随着微创方法引入外科领域，早期胃癌（EGC）的治疗理念已逐渐从追求标准化传统手术方法转变为精准、个体化、多学科协作管理。内镜治疗和腹腔镜手术在早期胃癌治疗中均有其局限性。与此同时，腹腔镜与内镜联合手术（LECS）结合了内镜检查和腹腔镜检查的优势，可进行局部胃切除和区域淋巴结清扫，为早期胃癌根治性切除提供了一种更有效的手术方法。LECS在早期胃癌治疗中的应用不断增加，从最初的腹腔镜辅助内镜全层切除发展到多种改良术式，如腹腔镜与内镜联合非暴露技术治疗肿瘤、非暴露内镜壁翻转手术，以及联合（前哨淋巴结引流区）区域淋巴结清扫或前哨淋巴结导航手术的可能性，这扩大了内镜手术的适应证，在确保根治性治疗的同时最大限度地保留了正常胃组织结构和功能，并且必将成为未来早期胃癌治疗的一个重要发展方向。
