中国实用外科杂志

中国实用外科杂志 ›› 2025, Vol. 45 ›› Issue (01): 69-74.DOI: 10.19538/j.cjps.issn1005-2208.2025.01.11

• 普通外科进展 • 上一篇    下一篇

提高腹腔镜胃癌根治术手术安全性的关键技术环节

王林俊，夏义文，徐泽宽   

  1. 南京医科大学第一附属医院普通外科 胃肿瘤中心，江苏南京210029
  • 出版日期:2025-01-01 发布日期:2025-01-27

  • Online:2025-01-01 Published:2025-01-27

摘要： 经过30年的发展，腹腔镜胃癌根治术已逐渐成熟，其适应证逐步扩大，已成为胃癌手术的主要方式之一。然而，腹腔镜胃癌根治术技术要求高，学习曲线长，操作难度大。如何提高腹腔镜胃癌根治术的手术安全性成为胃癌外科亟需解决的重要问题。文章针对腹腔镜胃癌根治术手术中的戳孔布局和气腹建立、探查和脱落细胞学检测、胃切除范围、淋巴结清扫规范、消化道重建方式选择等方面，对其技术要点进行了全面的梳理和归纳，以期为提高腹腔镜胃癌根治术的手术安全性提供参考。

关键词: 胃肿瘤, 腹腔镜, 胃癌根治术

Abstract: After nearly 30 years of development，the indications for laparoscopic radical gastrectomy have gradually expanded，making it an important method in the surgical treatment of gastric cancer.However，laparoscopic gastric cancer surgery is more technically demanding，has a longer learning curve，and requires higher technical proficiency.The improvement of surgical safety in laparoscopic radical gastrectomy is a critical issue that needs to be addressed.This article comprehensively reviews and summarizes the key technical points of laparoscopic radical gastrectomy，including the layout and establishment of trocar sites，pneumoperitoneum，exploration and cytology examination，extent of gastrectomy，standards for lymph node dissection，and selection of digestive tract reconstruction methods.The aim is to provide references for improving the safety of laparoscopic radical gastrectomy.

Key words: gastric tumor, laparoscopy, radical gastrectomy