胃癌淋巴结清扫辅助技术研究进展  

Research progress of assisted techniques for lymph node dissection in gastric cancer

作　　者：丁天龙 许博 王云鹏 张静[1] 王海云 何普毅 朱竞雨 陈昊[2,3] DING Tianlong;XU Bo;WANG Yunpeng;ZHANG Jing;WANG Haiyun;HE Puyi;ZHU Jingyu;CHEN Hao(Lanzhou University Second School of Clinical Medicine,Lanzhou 730030,P.R.China;Department of Tumor Surgery,Lanzhou University Second Hospital,Lanzhou 730030,P.R.China;Key Laboratory of Digestive System Tumors,Lanzhou University Second Hospital,Lanzhou 730030,P.R.China)

机构地区：[1]兰州大学第二临床医学院,兰州730030 [2]兰州大学第二医院肿瘤外科,兰州730030 [3]兰州大学第二医院消化系统肿瘤重点实验室,兰州730030

出　　处：《中国普外基础与临床杂志》2022年第4期534-538,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金项目(项目编号:81670594);甘肃省重点人才项目(项目编号:2019RCXM020);甘肃省科技计划项目(项目编号:19ZD2WA001);兰州市城关区科技计划项目(项目编号:2019RCCX0034);兰州市城关区科技计划项目(项目编号:2020SHFZ0039);兰州大学第二医院“萃英科技创新”计划项目(项目编号:CY2017-ZD01)。

摘　　要：目的了解胃癌淋巴结清扫辅助技术的研究进展。方法对近年来国内外关于淋巴结清扫辅助技术在胃癌根治术中应用研究的相关文献进行综述。结果目前用于胃癌根治术中淋巴结清扫的辅助技术主要有淋巴示踪技术和腹腔镜、机器人手术。淋巴示踪技术主要包括染料示踪剂、吲哚菁绿、γ探针、术中放射技术等的使用,其中γ探针和术中放射技术价格昂贵且术中放射技术具有辐射危害,不适宜临床推广应用,目前已少用。目前临床主要应用染料示踪剂和吲哚菁绿这两种淋巴示踪辅助技术对淋巴结进行示踪,其均可以提高检出率和增加淋巴结清扫的数量,改善患者的预后;腹腔镜胃癌根治术在淋巴结清扫数量方面不劣于传统的胃癌根治术,同时因其可视化、微创、术后恢复快、近期疗效好等优点在临床中得到了更加广泛的应用。机器人手术系统与常规的腹腔镜系统相比,更加精细、灵巧、稳定,回馈感更佳,更有利于特殊部位淋巴结的清扫。结论淋巴示踪剂的使用、腹腔镜及机器人技术的应用均可以提高淋巴结的检出率,改善患者的预后。Objective To investigate the research progress of assisted techniques for lymph node dissection in gastric cancer.Method The literatures on the applications of assisted techniques of lymph node dissection in the gastric cancer radical gastrectomy in recent years were reviewed.Results At present,the assisted techniques used for lymph node dissection in the radical gastrectomy mainly included the lymphatic tracing technology and laparoscopic and robotic surgeries.The lymphatic tracing technology mainly included the use of dye tracers,indocyanine green,gamma probe,intraoperative radiation technology,etc.Among which gamma probe and intraoperative radiation technology were expensive and not suitable for clinical application,and intraoperative radiation technology had a radiation risk,so it was rarely used currently.At present,the dye tracers and indocyanine green were mainly used in the clinical lymph node tracing,both of which could improve the detection rate and increase the number of lymph node dissection,and improve the prognosis of patients.The laparoscopic radical gastrectomy was not inferior to traditional radical gastrectomy in terms of lymph node dissection,and had been more widely used in the clinical practice due to its advantages of visualization,minimally invasive,quickly postoperative recovery,and good short-term efficacy.Compared with the conventional laparoscopic system,the robotic surgical system was more precise,dexterous,stable,and had a better feedback feeling,which was more conducive to the lymph node dissection of special location.Conclusion Use of lymphatic tracers,laparoscopy and robotics could increase lymph node detection rate and improve prognosis of patients.

关 键 词：胃癌 淋巴结清扫 淋巴示踪剂 根治性胃切除术 

分 类 号：R735.2[医药卫生—肿瘤]