腹腔镜胃癌手术质量控制相关问题  

Critical issues for quality control of laparoscopic gastrectomy for gastric cancer

作　　者：李子禹[1] 关广民 王胤奎[1] 陕飞[1] LI Zi-yu;GUAN Guang-min;WANG Yin-kui(Key laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Gastrointestinal Cancer Center,Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所、胃肠肿瘤中心一病区恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国实用外科杂志》2023年第9期966-970,共5页Chinese Journal of Practical Surgery

基　　金：北京市科技计划项目(No.A001671);首都卫生发展科研专项(No.A001666,No.A002108)。

摘　　要：手术是胃癌获得根治的主要手段。近年来腹腔镜胃癌手术因其微创、放大视野及精细操作等优势而得到快速推广,在胃癌手术中占比逐步提高。与开放手术相比,腹腔镜手术存在操作难度大、学习曲线长等特点。国内不同地区及医师间的技术差距也是腹腔镜胃癌手术发展过程中的必经阶段。由于腹腔镜手术技术要求高的特点,需要统一的质量控制及评价体系对其进行监督及规范。腹腔镜胃癌手术质量控制包括术前、术中、术后全流程的质量控制,涉及术前分期、风险及适应证评估,术中高质量、同质化手术操作,术后标本处理、并发症登记及随访等各个环节。统一规范的手术质量控制不仅是决定病人预后的关键因素,也是确保相关临床研究结论准确性的重要前提,同时能助力教学培训工作、安全度过学习曲线。Radical gastrectomy is the only possible curative treatment for gastric cancer.In recent years,laparoscopic gastrectomy has rapidly developed and gained popularity due to its advantages of minimal trauma,magnified vision and precise maneuvering.However,compared with open surgery,laparoscopic gastrectomy is greater complexity and has a longer learning curve.There is a technological gap between different physicians in China.The fact that laparoscopic gastrectomy is technically challenging necessitates the establishment of a standardized quality control system.The system should include precise preoperative staging,assessment of operative risks and indications,homogenized operation,specimen sampling,standardized complication registration and follow-up.Standardized quality control system is not only crucial to patient prognosis,but also a prerequisite to ensure the accuracy of clinical research.Additionally,it can also help trainees get through the learning curve as quickly as possible.In this article,we only discuss the critical aspects of quality control system of laparoscopic gastrectomy,such as the range of laparoscopic gastrectomy and lymph node dissection.

关 键 词：腹腔镜 胃癌 胃癌根治术 质量控制 胃切除范围 淋巴结清扫范围 

分 类 号：R6[医药卫生—外科学]