Minimally Invasive Function-Preserving Gastrectomy with Sentinel Node Biopsy for Early Gastric Cancer
Minimally Invasive Function-Preserving Gastrectomy with Sentinel Node Biopsy for Early Gastric Cancer
复制标题
DOI：
10.1159/000494407
复制
发表时间：
2019-01-01
期刊：
影响因子：
3.2
通讯作者：
Kitagawa, Yuko
中科院分区：
文献类型：
--
作者：
Hiramatsu, Yoshihiro;Takeuchi, Hiroya;Kitagawa, Yuko
背景：近年来，内镜治疗或腹腔镜胃切除术等微创方式治疗早期胃癌进展迅速。然而，腹腔镜手术的胃切除术和淋巴结切除术的范围是彻底的，类似于早期诊断为不需要内镜治疗的胃癌患者的开放式胃切除术。由于众所周知，淋巴结转移是一个重要的预后因素，为了达到治愈性切除的目的，胃切除术的标准程序是根治性淋巴结清扫。早期胃癌患者淋巴结转移的发生率相对较低；因此，保留功能的胃切除术是介于内镜治疗和标准胃切除术之间的一种解决方案，可以考虑避免手术过度的侵入性。摘要：一项前瞻性多中心试验和荟萃分析显示，早期胃癌前哨淋巴结（SN）定位和活检的检出率和淋巴结转移状态的准确性都很好。基于SN理论的个性化保功能胃切除术加有限淋巴结切除术对患者的生活质量（QOL）有积极影响。具体而言，腹腔镜内镜下全层胃部分切除术联合SN盆清扫术可成为治疗临床淋巴结阴性（cN0）早期胃癌患者的一种可靠的微创胃切除术技术。关键词：对于早期胃癌，腹腔镜个性化微创胃切除术配合SN导航的发展可能会提高患者的术后生活质量。(C) 2018 S. Karger AG，巴塞尔
Background: Recently, minimally invasive approaches such as endoscopic treatment or laparoscopic gastrectomy for early gastric cancer have made rapid progress. However, the extent of gastrectomy and lymphadenectomy in laparoscopic surgery is radical, similar to that of open gastrectomy for patients with early gastric cancer diagnosed as not indicated for endoscopic treatment. Since it is well known that lymph node metastasis is an important prognostic factor, the standard procedure of gastrectomy with radical lymph node dissection has been performed for the purpose of curative resection. The frequency of lymph node metastases is relatively low in patients with early gastric cancer; therefore, function-preserving gastrectomy, a solution between endoscopic treatment and standard gastrectomy in terms of invasiveness, could be considered to avoid excessive invasive surgery. Summary: A prospective multicenter trial and meta-analyses of sentinel node (SN) mapping and biopsy for early gastric cancer demonstrated favorable SN detection rates and accuracy of nodal metastatic status. Personalized function-preserving gastrectomy with limited lymphadenectomy using SN theory will positively impact patients' quality of life (QOL). Specifically, a full-thickness partial gastrectomy by laparoscopic endoscopic cooperative surgery with SN basin dissection could become a reliable technique of minimally invasive gastrectomy for treating patients with clinically node-negative (cN0) early gastric cancer. Key Messages: For early gastric cancer, the development of laparoscopic personalized minimized gastrectomy with SN navigation may improve patients' postoperative QOL. (C) 2018 S. Karger AG, Basel