肿瘤代谢手术:胃癌根治与2型糖尿病缓解或可兼得  

Onco-metabolic surgery:the bridge between curative resection of gastric cancer and the remission of type 2 diabetes mellitus

作　　者：程吕佳 伍振鹏 乔钰涵 江云颂 向林 吴丽娜[1] 关炳生 汤汉林[1] 黄世芳[2] 杨景哥[1] Cheng Lyujia;Wu Zhenpeng;Qiao Yuhan;Jiang Yunsong;Xiang Lin;Wu Lina;Guan Bingsheng;Tang Hanlin;Huang Shifang;Yang Jingge(Gastrointestinal Surgery,Obesity and Metabolic Disease Surgery,the First Affiliated Hospital of Jinan University,Guangzhou510630,China;Department of Critical Care Medicine,the First Affiliated Hospital of Jinan University,Guangzhou510630,China)

机构地区：[1]暨南大学附属第一医院胃肠外科、肥胖与代谢病外科,广州510630 [2]暨南大学附属第一医院重症医学科,广州510630

出　　处：《中华胃肠外科杂志》2024年第11期1178-1185,共8页Chinese Journal of Gastrointestinal Surgery

基　　金：广州市科技计划项目(202201020064)。

摘　　要：胃癌与2型糖尿病(T2DM)的密切关系尤其引发关注,一方面,T2DM可能参与胃癌的发生发展,与患者不良预后相关;另一方面,胃癌患者接受根治性外科手术后,其T2DM也能得到较好控制,并有望改善肿瘤预后。近些年,减重代谢手术(BMS)为肥胖和超重患者T2DM治疗带来划时代的变革。比较发现,胃癌外科术式与BMS存在诸多相似之处,肿瘤代谢手术(OMS)理念因此出现,即外科医生有望通过一次手术,同时实现胃癌患者的肿瘤根治和T2DM的缓解。然而,OMS与BMS又有着诸多不同,包括适用人群、手术细节和围手术期管理等。因此,如何优化OMS理念在胃癌患者中的应用,临床意义重大。本文将对此做一综述,以期更好推行这一理念的实践。The close relationship between gastric cancer(GC)and type 2 diabetes mellitus(T2DM)has garnered significant attention.On one hand,T2DM may play a role in the development and progression of GC,correlating with poor patient outcomes.On the other hand,after radical surgery for GC,T2DM can be effectively managed,potentially improving tumor prognosis.In recent years,bariatric and metabolic surgery(BMS)has revolutionized T2DM treatment for obese and overweight patients.Comparative analyses reveal similarities between surgical approaches for gastric cancer and BMS,leading to the emergence of the onco-metabolic surgery(OMS)concept,which suggests that radical tumor resection and T2DM remission in GC patients can be potentially achieved through a single procedure.However,there are notable differences between OMS and BMS,including target populations,surgical details,and perioperative management.Therefore,optimizing the application of the OMS concept in GC patients holds significant clinical importance.This article provides a review to facilitate the better implementation of this concept in practice.

关 键 词：胃肿瘤 2型糖尿病 肿瘤代谢手术 减重代谢手术 

分 类 号：R735.2[医药卫生—肿瘤] R587.1[医药卫生—临床医学]