功能保留胃切除术的发展历程与未来创新方向  

Evolution of functional preserving gastrectomy:where are we today?

作　　者：Che Ani Mohd Firdaus Jeesun Kim Yang Han-Kwang Che Ani Mohd Firdaus;Jeesun Kim;Yang Han-Kwang(Department of Surgery,Faculty of Medicine,University Teknologi MARA,Sungai Buloh 40450,Malaysia;Gastrointestinal Surgery Division,Seoul National University Hospital,Seoul 03080,South Korea)

机构地区：[1]玛拉工艺大学医学院外科系,马来西亚双溪布洛40450 [2]首尔大学医学院胃肠外科,韩国首尔03080

出　　处：《中华消化外科杂志》2025年第1期52-57,共6页Chinese Journal of Digestive Surgery

摘　　要：近年来,功能保留胃切除术因其术后并发症少且能维持传统胃切除术的肿瘤学疗效而备受青睐。笔者从PubMed数据库检索了包含"function-preserving surgery""pylorus-preserving surgery""proximal gastrectomy"和"fluorescence-guided surgery"等关键词的文章,获取相关文献并进行分析。胃切除术的发展旨在改善患者的总体结局,包括肿瘤学、安全性、生命质量及功能表现。传统观点认为:广泛切除原发肿瘤周围组织可获得最佳疗效。然而,随着现代技术的进步,越来越多的证据表明并非如此。有关肿瘤学安全性的研究结果显示:对于早期胃癌患者,有限的淋巴结清扫已经足够。辅助技术的进步显著改善了肿瘤外科手术方式。手术技术和显像设备的改进促进了更多微创手术的应用。荧光引导手术进一步为外科医师术中实时决策提供了支持。对于符合相应适应证的患者,临床实践指南已将功能保留手术纳入可接受的手术方式并提供了详细适应证。部分正在进行的研究结果将强化循证证据,表明功能保留手术是提高早期胃癌患者整体效果的可靠选择。Function-preserving gastrectomy has gained popularity in recent times for having less postoperative morbidity while able to maintain the oncological efficacy of conventional gastrec-tomies.Articles obtained from online databases through PubMed using keywords"function-preser-ving surgery""pylorus-preserving surgery""proximal gastrectomy"and"fluorescence-guided surgery".The evolution of gastrectomies was aimed to improve the patients′overall outcome,including onco-logy,safety,quality of life,and functional performance.It was traditionally believed that extensive resection of tissues surrounding the primary tumour would give the best possible outcomes.However,with the help of technology today,more evidence has surfaced proving that it is no longer necessary.Oncological safety studies have shown that limited lymph node resection is adequate in early gastric cancer.Technology aid has come a long way to complement how to approach oncology surgery.Improved optics and display technology have increased the adoption of more minimally invasive surgery.Fluorescence-guided surgery has further complemented surgeons with real-time information for better on-table decisions.Clinical practice guidelines are now recommending function-preser-ving surgery as part of an accepted surgical option with detailed indications.A few ongoing studies further strengthen the evidence to suggest that functional-preserving surgery is a reliable choice to improve overall outcome for patient care in early gastric cancer.

关 键 词：胃肿瘤 功能保留胃切除术 保留幽门胃切除术 近端胃切除术 疗效 

分 类 号：R735.2[医药卫生—肿瘤]