完全腹腔镜下远端胃癌根治术经自然腔道取标本手术的过去、现在和未来  

Completely laparoscopic radical treatment of distal gastric cancer through natural orifice specimen extraction surgery:past,present,and future

作　　者：李微波 丁东兵 梁荣朴 黄河[1] 赵阳 魏波[1] Li Weibo;Ding Dongbing;Liang Rongpu;Huang He;Zhao Yang;Wei Bo(Department of Gastrointestinal Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou510630,China)

机构地区：[1]中山大学附属第三医院胃肠外科,广州510630

出　　处：《中华胃肠外科杂志》2024年第11期1172-1177,共6页Chinese Journal of Gastrointestinal Surgery

基　　金：中山大学临床研究“5010”计划项目(2023011);中山大学附属第三医院五个五工程项目(2023WW502)。

摘　　要：胃癌是消化系统常见的恶性肿瘤,传统腹腔镜胃癌根治术是治疗胃癌的重要手段,但其标本取出造成的腹部创伤与当今微创外科理念不符。经自然腔道取标本手术(NOSES)作为一种新兴的微创手术方式,具有创伤小、术后康复快及术后疼痛轻等优势,已越来越多地应用于胃肠肿瘤患者中。近年来,结直肠癌NOSES技术在国内的广泛应用,为胃癌微创治疗提供了理论支持。且随着我国社区体检的规范化开展,早期胃癌的病例将不断增加,NOSES手术必然会成为未来早期胃癌手术治疗的趋势。然而,目前国内外对这一领域的探索不足,本文拟综合以往的文献资料,阐述完全腹腔镜下远端胃癌根治经自然腔道取标本手术的发展历史、研究现状、优缺点、技术难点、面临的挑战和未来方向。Gastric cancer is a prevalent malignancy of the digestive system,and traditional laparoscopic radical gastrectomy remains a crucial treatment modality.However,the abdominal wound associated with specimen removal during this procedure conflicts with contemporary concept of minimally invasive surgery.Natural orifice specimen extraction surgery(NOSES)is an emerging minimally invasive surgical technique that has gained increasing utilization in patients with gastrointestinal tumors,owing to its benefits of reduced wound,accelerated postoperative recovery,and diminished postoperative pain.In recent years,the extensive application of NOSES technology for colorectal cancer in China has provided theoretical support for the minimally invasive treatment of gastric cancer.With the standardization of community health examinations in China,the incidence of early gastric cancer diagnoses is expected to rise,making NOSES surgery the likely future trend in the surgical treatment for early gastric cancer.However,this area remains under-explored both domestically and internationally.This paper aims to synthesize prior literature and review the historical development,current research status,advantages and disadvantages,technical challenges,and future directions of completely laparoscopic radical treatment of distal gastric cancer utilizing NOSES.

关 键 词：胃肿瘤 远端 腹腔镜 自然腔道取标本手术 进展 

分 类 号：R735.2[医药卫生—肿瘤]