胃癌围手术期优化管理的研究进展  

Advancements in perioperative optimal management of gastric cancer

作　　者：相小松 苏钰 郭飞龙(综述) 李国立(审校) XIANG Xiaosong;SU Yu;GUO Feilong;LI Guoli(Research Institute of General Surgery,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China;Department of General Medicine,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院全军普通外科研究所,南京210002 [2]东部战区总医院全科医学科,南京210002

出　　处：《医学研究与战创伤救治》2024年第6期663-668,共6页Journal of Medical Research & Combat Trauma Care

基　　金：江苏省医学创新中心项目(CXZX202217);东部战区总医院临床研究专项基金(22LCYY-XH11)。

摘　　要：胃癌是我国高发恶性肿瘤,生存预后较差。根治性手术仍是其唯一可能的治愈手段。然而有证据显示,手术创伤产生的应激会增加肿瘤细胞种植转移风险。文章主要就手术应激引起的炎症、交感神经系统兴奋、高凝、免疫抑制等病理生理状态对胃癌复发的影响进行综述,并提出包括镇痛、免疫调节、营养治疗等以微创手术为核心的进展期胃癌围手术期优化管理方案,以期最大限度减少手术应激对肿瘤进展的影响,改善胃癌患者预后。Gastric cancer with poor prognosis is common in China.Radical surgery remains the only possible curative option.However,evidence suggested that surgical stress can increase the risk of implantation and metastasis in tumor cell.This review empha-sized the impact of pathophysiological states caused by surgical stress,including inflammation,sympathetic nervous system activation,hypercoagulability,and immunosuppression,on the recurrence of gastric cancer.It proposed perioperative optimal management strate-gies for advanced gastric cancer centered on minimally invasive surgery,which include analgesia,immunomodulation,and nutritional therapy.The aim is to minimize the impact of surgical stress on tumor progression and improve the prognosis of patients with gastric cancer.

关 键 词：胃癌 根治性手术 外科应激 围手术期治疗 

分 类 号：R735.2[医药卫生—肿瘤]