Abstract:

Controversy and consensus on the treatment of early gastric cancer　　LIANG Han,ZHANG Li.Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital；National Clinical Research Center of Cancer；Key Laboratory of Cancer Prevention and Therapy, Tianjin300060, China
Corresponding author：LIANG Han ,E-mail:tjlianghan@126.com
Abstract　Early gastric cancer has its unique behavioral characteristics, and there are controversies and consensus in many aspects of treatment. In the past, the treatment of early gastric cancer was based on the traditional open standard gastrectomy and lymph node dissection. In recent years, with the improvement of detection rate of early gastric cancer and the advancement of surgical equipment in China. The surgical treatment for early gastric cancer has gradually changed to minimally invasive surgery represented by endoscopy and laparoscopic or robot, and functional gastrectomy with preserving normal anatomical and physiological functions of the stomach to improve the quality of life of patients after radical treatment.The treatment mode of early gastric cancer is multidisciplinary and accurate. Endoscopic treatment is the first choice for patients with early gastric cancer, and its minimally invasive advantage is more obvious. For non-endoscopic patients, endoscopic and laparoscopic co-oprative surgery is the future direction of development.

Key words: early gastric cancer, gastrectomy, endoscopy, laparoscopy

摘要：

早期胃癌有其独特的行为特点，治疗的诸多方面都存在争议与共识。既往早期胃癌治疗以传统追求肿瘤根治的开腹标准胃切除和淋巴结清扫手术为主。近年来，随着我国早期胃癌检出率的提高以及外科手术器材的进步，针对早期胃癌所实施的外科治疗逐步转变为以内镜及腹腔镜机器人为代表的微创手术，以及在肿瘤根治条件下最大限度地保留胃的正常解剖和生理功能以改善治疗后病人生活质量的功能保留性胃切除术。早期胃癌的治疗模式呈现多学科化、精准化特点，对符合适应证的早期胃癌病人，内镜治疗是首选，其微创优势更加明显。对于非内镜治疗适应证的病人，内镜与腹腔镜的双镜联合手术是未来的发展方向。

关键词: 早期胃癌, 胃切除术, 内镜, 腹腔镜