胃癌手术临床试验新进展

【Author】

Takashi Kiyokawa;Takeo Fukagawa;

【Institution】

Department of Surgery, Teikyo University School of Medicine;

【Abstract】

日本临床肿瘤组最近进行了一项大规模临床试验,结果揭示了可切除的胃癌手术治疗的关键策略。研究发现:与D2淋巴结清扫术相比,D3淋巴结清扫术不能提高生存率,且不推荐用于可切除的胃癌。此外,对于侵犯食管≤3 cm的食管–胃交界处或胃贲门腺癌的治疗,建议采用经食管裂孔入路,而非左胸腹入路。过去建议将胃切除伴脾切除术和网膜囊切除术作为D2淋巴结清扫术的一部分。然而,最近的临床试验结果显示,对于近端胃癌,伴D2淋巴结清扫的全胃切除术应避免脾切除术;对于可切除的胃癌,伴D2淋巴结清扫的胃切除术应避免网膜囊切除。脾切除术和网膜囊切除术均不能提高生存率,反而增加手术并发症。这些试验结果表明,上述侵入性和激进性手术未能使患者得到生存获益,胃癌手术可能将向"从侵入性到低侵入性"和"从激进到较保守"的趋势发展。

【Keywords】

胃癌;;日本胃癌学会;;随机临床试验;;主动脉旁淋巴结;;D2淋巴结清扫术;;D3淋巴结清扫术;;左胸腹入路;;食管裂孔入路;;脾切除术;;网膜囊切除术

References

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Springer Journals Database

Total: 23 articles

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