试析腹腔镜胃癌根治术淋巴结清扫的相关问题  

Issues of lymphadenectomy in laparoscopic gastrectomy for gastric cancer

作　　者：李子禹[1] 高翔宇[1] 贾永宁[1] Li Ziyu;Gao Xiangyu;Jia Yongning(The 1st department of gastrointestinal tumor center,Cancer hospital,Peking University,100142)

机构地区：[1]北京大学肿瘤医院胃肠肿瘤中心一病区,100142

出　　处：《中华普外科手术学杂志（电子版）》2018年第2期99-102,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：北京市医院管理局重点医学专业发展计划胃癌专业(ZYLX201701);首都临床特色应用发展项目(Z151100004015070)~~

摘　　要：手术是胃癌治疗的基石,但关于淋巴结清扫的范围东西方学者一度有过争论。基于2010年Dunch研究15年随访结果,D2淋巴结清扫作为进展期胃癌治疗的标准术式方得到普遍认同。至此也为胃癌腹腔镜淋巴结清扫术的应用奠定基础,开启了胃癌外科治疗的新纪元。自从1994年日本Kitano教授进行了首例腹腔镜手术治疗早期胃癌以来,其应用于胃癌的证据越来越多,现已被日本胃癌治疗指南推荐为早期远端胃癌的标准治疗选择。在我国,依据中国胃肠肿瘤外科联盟收集2014年至2016年间3年来自全国73家中心88000余例胃癌手术病例数据来看,接受腔镜手术患者的比例已超过30%,并呈每年上升趋势。由于腹腔镜手术具有微创、视野放大、操作精细、便于沟通、交流及学习等特点,其将具有更广阔的应用前景。本文结合笔者团队既往的经验,讨论腹腔镜下胃癌淋巴结清扫的特点。希望借此文对读者有所启发。There once remained a controversy concerning the range of lymphadenectomy between Eastern and Western scholars;however,based on the results from 15-year follow-up Dunch trial in 2010,D2 lymphadenectomy has been generally accepted as the standard surgical procedure for gastric cancer treatment.So far,the foundation for laparoscopic lymphadenectomy in gastric cancer surgery has been set up,and a new era of surgical treatment for gastric cancer has arisen.In 1994,Prof.Kitano performed the first laparoscopic surgery for early gastric cancer,since when increasing evidence has proved that laparoscopic surgery can replace partial open surgery and has already been recommended by the Japanese Gastric Cancer Treatment Guidelines as a standard treatment option for early distal gastric cancer.In China,according to the data collected by China Gastrointestinal Cancer Surgery union(CGCSU)from 2014 to 2016,among 88,000 cases of gastric cancer in 73 centres across the country,the proportion of laparoscopic

关 键 词：胃肿瘤 腹腔镜检查 胃切除术 淋巴结切除术 

分 类 号：R735.2[医药卫生—肿瘤]