外科新理念和新技术在可切除型胃癌肝转移患者中的发展和应用  

Progress and implementing of novel surgical concepts and techniques in patients with resectable gastric cancer liver metastasis

作　　者：高云鹤[1] 李力[2] 陈凛 Gao Yunhe;Li Li;Chen Lin(Senior Department of General Surgery,the First Medical Center,Chinese People′s Liberation Army General Hospital,Beijing 100853,China;Graduate School,Chinese People′s Liberation Army Medical School,Beijing 100853,China;Department of Gastrointestinal Surgery,Peking University International Hospital,Beijing 100871,China)

机构地区：[1]解放军总医院第一医学中心普通外科医学部,北京100853 [2]解放军总医院研究生院,北京100853 [3]北京大学国际医院胃肠外科,北京100871

出　　处：《中华外科杂志》2024年第5期359-363,共5页Chinese Journal of Surgery

基　　金：国家自然科学基金(81972790);军队装备综合研究计划(LB2022B020200-QZ)。

摘　　要：近年来,随着外科技术的进步和相关理念的更新,胃癌肝转移患者的治疗策略和预后亦有了长足的进步,其中又以初始可切除型的患者尤为令人瞩目。尽管各共识和指南对于初始可切除型胃癌肝转移的定义不尽相同,但外科手术切除或肝脏局部物理疗法在综合治疗中的地位日益重要。同时,多学科综合诊疗模式和外科微创理念的发展为患者提供了更为个性化和微创化的治疗方案。根据胃癌肝转移中国专家共识系统对患者进行精准临床分型,在诊断和治疗全程贯彻多学科诊疗理念,再根据患者的全身和疾病情况选择适当的外科手术和物理治疗方式,辅以病理学分子分型指导下的全身综合治疗,是目前可切除型胃癌肝转移患者的最佳临床路径。上述诊疗策略仍须高质量的临床研究数据进一步证实和细化。In recent years,advances in surgical techniques and evolving concepts have significantly improved treatment strategies and prognosis for patients with gastric cancer liver metastases.In particular,patients diagnosed with initially resectable gastric cancer liver metastases shows marked improvement in survival.Despite variations in the definition of initially resectable gastric cancer liver metastases among different consensus and guidelines,surgical resection and hepatic physiotherapy are increasingly crucial components of comprehensive treatment.Meanwhile,the advancement of the multidisciplinary team model for diagnosis and treatment,along with the evolution of minimally invasive surgical concepts,offers patients increasingly personalized and less intrusive therapeutic alternatives.According to the Chinese Consensus Classification System for Gastric Cancer Liver Metastasis,the optimal clinical pathway for patients initially diagnosed with resectable gastric cancer liver metastasis involves precise categorization,guided selection of surgical approaches and physiotherapy using the multidisciplinary team model,and consideration of molecular classification.However,the refinement and confirmation of these clinical strategies is still required through high-quality clinical trials.

关 键 词：胃肿瘤 肿瘤转移 外科手术 外科新理念 外科新技术 

分 类 号：R735.2[医药卫生—肿瘤]