局部进展期胃癌新辅助免疫治疗后微创外科治疗的应用现状与进展  

Current status and recent advances in the application of mini-invasive gastrectomy after neoadjuvant immunotherapy for locally advanced gastric cancer

作　　者：崔昊 卫勃[1,2] Cui Hao;Wei Bo(Department of General Surgery,First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;School of Medicine,Nankai University,Tianjin 300071,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]南开大学医学院,天津300071

出　　处：《腹部外科》2024年第4期231-236,共6页Journal of Abdominal Surgery

摘　　要：新辅助免疫治疗已成为提升局部进展期胃癌(locally advanced gastric cancer,LAGC)治疗效果的有效方式。在微创外科时代,新辅助免疫治疗带来的良好肿瘤学响应、治疗相关不良事件及对术区组织的潜在影响与围手术期安全性及远期生存关系密切。现有证据认为LAGC新辅助免疫治疗后行微创手术尽管操作难度较大,但整体安全可行,远期生存相当。在此基础上,应积极推动临床合作,聚焦新辅助免疫治疗后手术时机选择、淋巴结个体化清扫、功能保留性微创手术等关键问题,以规范及拓展微创手术在LAGC新辅助免疫治疗后外科治疗的适应证。Neoadjuvant immunotherapy has become an effective modality for enhancing the therapeutic efficacy of locally advanced gastric cancer(LAGC).In modern era of mini-invasive surgery,favorable tumor response,treatment-related adverse events and potential impact on perioperative tissues from neoadjuvant immunotherapy are correlated closely with perioperative safety and long-term survival.Current evidence suggests that mini-invasive gastrectomy after neoadjuvant immunotherapy is both safe and feasible with comparable short-term outcomes and long-term survival despite intraoperative difficulties.On this basis,clinical cooperation should be actively promoted for addressing such key issues as timing of surgery after neoadjuvant immunotherapy,individualized lymph node dissection and function-preserving mini-invasive gastrectomy to standardize and expand the indications for mini-invasive gastrectomy after neoadjuvant immunotherapy for LAGC.

关 键 词：微创 胃癌 新辅助治疗 免疫治疗 

分 类 号：R656[医药卫生—外科学]