[Laparoscopic proximal gastrectomy and lymph node resection in adenocarcinoma of the esophagogastric junction].

医学 解剖(医学) 淋巴结 胃切除术 癌症 普通外科 腺癌 外科 腹腔镜手术 腹腔镜检查 内科学
作者
Jue Zhao,F L Liu
出处
期刊:PubMed 卷期号:25 (2): 114-119 被引量:1
标识
DOI:10.3760/cma.j.cn441530-20211103-00446
摘要

The proportion of adenocarcinoma of the esophagogastric junction (AEG) in gastric cancer is gradually increasing. Due to the unique anatomical structure and biological characteristics of the tumor at this site, AEG has a certain degree of complexity in many aspects of diagnosis and treatment, which brings difficulties to the operation method, the selection of the resection range, the lymph node dissection and the treatment decision-making. Therefore, AEG has always been the focus of academic debate. With the development of minimally invasive surgery in recent years, laparoscopic technology has been increasingly mature and widely used in the treatment of gastrointestinal tumors. Compared with distal gastric cancer, the minimally invasive treatment of AEG is in a lagging state, and there are also a series of problems that have not yet reached a consensus. This article reviews and summarizes the recent research progress in two aspects: proximal gastrectomy for AEG and lymph node dissection. Laparoscopic-assisted proximal gastrectomy is safe for early proximal gastric cancer and has a long-term survival outcome not inferior to total gastrectomy, but the surgical indications must be strictly selected. Abdominal lymph node metastasis of AEG is mainly in group 1, 2, 3, and 7, and mediastinal lymph node metastasis is closely related to the length of the infiltrated esophagus. The abdominal transhiatal (TH) approach can obtain a sufficient number of harvested lymph node, and has good safety and efficacy, which is the first-choice of surgical approach for early AEG. The results of the CLASS-10 clinical trial can provide a higher level of evidence for laparoscopic mediastinal lymph node dissection. Laparoscopic surgery for AEG should be carried out in experienced medical center based on clinical research.食管胃结合部腺癌(AEG)在胃癌中的比例呈逐步上升的趋势。由于该部位的肿瘤具有独特的解剖结构及生物学特征,使其在诊断、治疗的多个方面具有一定复杂性,给手术方式、切除范围的选择、淋巴结清扫、治疗决策的制订等带来诸多的难度,也因此一直是学术争论的焦点。随着近年来微创外科的发展,腹腔镜技术已不断成熟并广泛应用于消化道肿瘤的治疗。相比于远端胃癌,AEG的微创治疗处于发展相对滞后的状态,也有一系列的问题尚未明确。本文围绕AEG近端胃切除术及淋巴结清扫两个方面对近年来的研究进展进行了回顾和总结。腹腔镜辅助近端胃大部切除术对于早期近端胃癌是安全的,并且具有与全胃切除相似的远期疗效,但需严格把握手术指征。AEG的腹腔淋巴结转移以No.1、No.2、No.3、No.7淋巴结为主,而纵隔淋巴结转移与浸润食管的距离密切相关。经腹食管裂孔入路(TH)可以获得足够的淋巴结清扫数目,且具有较好的安全性和有效性,是早期AEG首选的手术入路。CLASS-10的研究结果可以为腹腔镜纵隔淋巴结清扫提供更高级别的循证学依据。AEG的腹腔镜手术应在经验丰富的单位谨慎开展,并应注重临床研究开展。.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
李浩然发布了新的文献求助10
1秒前
笑点低嵩发布了新的文献求助10
3秒前
柯柯完成签到,获得积分20
3秒前
3秒前
dodo发布了新的文献求助10
4秒前
谢文强完成签到,获得积分10
6秒前
爱吃饼干的土拨鼠完成签到,获得积分10
9秒前
mhl11应助科研老王采纳,获得10
9秒前
QI发布了新的文献求助10
11秒前
隐形的半鬼完成签到 ,获得积分10
11秒前
songjinyan829完成签到,获得积分10
12秒前
13秒前
14秒前
17秒前
大模型应助LV采纳,获得10
17秒前
heshuyao完成签到,获得积分10
17秒前
OKC发布了新的文献求助10
20秒前
dodo完成签到,获得积分10
20秒前
在水一方应助笑点低嵩采纳,获得10
21秒前
21秒前
Ray完成签到,获得积分20
22秒前
wanci应助QI采纳,获得10
22秒前
23秒前
李健的小迷弟应助柒月采纳,获得10
23秒前
明亮梦山完成签到 ,获得积分10
27秒前
科目三应助疾风采纳,获得10
28秒前
拉长的冰海完成签到 ,获得积分10
29秒前
wwt发布了新的文献求助10
29秒前
手机应助古月方源采纳,获得10
30秒前
31秒前
34秒前
bkagyin应助冷静的方盒采纳,获得10
34秒前
zhh发布了新的文献求助10
34秒前
zhaoman完成签到,获得积分10
34秒前
太阳星辰发布了新的文献求助10
35秒前
35秒前
殷勤的凝海完成签到 ,获得积分10
35秒前
大模型应助小鱼采纳,获得10
37秒前
Ray关注了科研通微信公众号
37秒前
高分求助中
Rock-Forming Minerals, Volume 3C, Sheet Silicates: Clay Minerals 2000
The late Devonian Standard Conodont Zonation 2000
Nickel superalloy market size, share, growth, trends, and forecast 2023-2030 2000
The Lali Section: An Excellent Reference Section for Upper - Devonian in South China 1500
The Healthy Socialist Life in Maoist China 600
The Vladimirov Diaries [by Peter Vladimirov] 600
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3267870
求助须知:如何正确求助?哪些是违规求助? 2907285
关于积分的说明 8341469
捐赠科研通 2577939
什么是DOI,文献DOI怎么找? 1401436
科研通“疑难数据库(出版商)”最低求助积分说明 655037
邀请新用户注册赠送积分活动 634076