Chinese Journal of Practical Surgery

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  • Online:2022-10-01

早期胃癌行前哨淋巴结导航手术的探索与实践

黄昌明,林光锬,吴    栋   

  1. 福建医科大学附属协和医院胃外科  福建医科大学消化道恶性肿瘤教育部重点实验室,福建福州 350004

Abstract: The initial exploration and clinical practice of sentinel node navigation surgery in early gastric cancer                           HUANG Chang-ming, LIN Guang-yan, WU Dong. Department of Gastric Surgery, Fujian Medical University Union Hospital & Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou 350004, China 
Corresponding author: HUANG Chang-ming, E-mail:hcmlr
2002@163.com
Abstract    With the popularization of endoscopic screening, the proportion of early gastric cancer in China has gradually increased, which has brought about widespread attention. Owing to the advance in surgical technique and the accumulation of treatment experience, improvement in prognosis has been seen in early gastric cancer patients after radical gastrectomy. With gastric surgery advancing towards minimally invasive, precise, and individualized, reducing surgical trauma, preserving function, and improving the quality of life have become the latest demands of the new era. Many scholars have attempted a lot in this field. Sentinel lymph node navigation surgery (SNNS) has emerged based on the lymphatic flow of gastric cancer, supported by the matured technique of sentinel lymph node tracer and the intraoperative rapid pathological diagnosis. Although tremendous amounts of previous literature demonstrate the blueprint of SNNS application, its safety, feasibility, and potential advantages still need to be confirmed by large-scale international multi-center prospective clinical studies. Moreover, the technical barriers and quality control of this operation hinder its wider popularization. 

Key words: early gastric cancer, sentinel node navigation surgery, prognosis, quality of life

摘要: 随着早期癌症筛查的普及,我国早期胃癌的比例逐渐升高,引起了广泛的关注。得益于外科技术的成熟和治疗经验的积累,早期胃癌行根治性手术后病人预后显著改善。随着胃癌外科朝着微创化、精准化和个体化发展,如何在确保肿瘤根治的前提下,尽可能减少手术创伤,保留功能和改善生活质量成为新的时代需求。许多学者为此进行了大量的探索和实践,以胃癌淋巴回流途径为理论基础,前哨淋巴结示踪和术中快速病理学诊断为技术保障的前哨淋巴结导航手术应运而生。虽然大量前期研究表明前哨淋巴结导航手术具有良好的应用前景,但其安全性、可行性和潜在优势仍需大规模的国际多中心前瞻性临床研究证实,且该术式存在的技术壁垒和质量控制阻碍了更广泛的开展。

关键词: 早期胃癌, 前哨淋巴结导航手术, 预后, 生活质量