摘要
我国是胃癌发病大国,其中进展期胃癌患者占大多数,当前局部进展期胃癌的围手术期诊疗模式已有了深刻变化。患者在新辅助治疗后接受胃癌根治术并联合术后辅助治疗已成为东西方胃癌诊疗指南逐步推荐的诊疗流程。新辅助治疗可使胃癌降级降期,有助于胃癌根治术的顺利开展,并且可根据治疗反应进一步筛选药物,经验性指导辅助治疗。但新辅助治疗后,肿瘤组织及机体全身势必也会产生一系列变化,对胃癌根治术的实施过程、术后管理产生影响。因此,本文拟围绕胃癌新辅助治疗的指征和进展、根治术的实施时机、技术要点和术后并发症等方面进行探讨,以期为业内同道提供借鉴和参考。
China is a major country for gastric cancer incidence,with the majority being at the advanced stage.Currently,there has been a profound change in the perioperative diagnosis and treatment mode of locally advanced gastric cancer.It has become a gradually recommended diagnostic and treatment process in both eastern and western countries gastric cancer guidelines for patients to undergo radical surgery for gastric cancer after neoadjuvant therapy,followed by postoperative adjuvant therapy.Neoadjuvant therapy can downregulate the tumor grade and clinical stage of gastric cancer,facilitating the successful conduct of radical surgery for gastric cancer.Moreover,it allows for further therapeutic selection based on treatment response and empirically guides adjuvant therapy.However,after neoadjuvant therapy,tumor tissue and the whole body of the patient will inevitably undergo a series of changes,which will affect the implementation process of radical surgery for gastric cancer and postoperative management.Therefore,this article intends to discuss the indications and progress of neoadjuvant therapy for gastric cancer,the timing of radical surgery,technical points,postoperative complications,and other aspects,in order to provide reference and guidance for colleagues in the industry.
作者
高云鹤
陈亚文
刘培发
乔治
Gao Yunhe;Chen Yawen;Liu Peifa;Qiao Zhi(Department of General Surgery,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《国际外科学杂志》
2024年第5期289-293,共5页
International Journal of Surgery
基金
2022年度军队装备综合研究计划课题(LB2022B020200-QZ)。
关键词
胃肿瘤
手术后并发症
肿瘤辅助疗法
新辅助治疗
胃癌根治术
技术要点
并发症
Stomach neoplasms
Postoperative complications
Neoadjuvant therapy
Neoadjuvant therapy
Gastrectomy
Technical points
Postoperative complications
