外科理论与实践 ›› 2023, Vol. 28 ›› Issue (03): 233-239.doi: 10.16139/j.1007-9610.2023.03.010
收稿日期:
2023-05-10
出版日期:
2023-05-25
发布日期:
2023-08-18
通讯作者:
郑民华
E-mail:zmhtiger@yeah.net
Received:
2023-05-10
Online:
2023-05-25
Published:
2023-08-18
Contact:
ZHENG Minhua
E-mail:zmhtiger@yeah.net
摘要:
腹腔镜手术在胃癌领域的应用与发展经历了20余年,从探索性开展,到临床验证,再到大规模临床研究,获得高级别循证医学证据的支持。腹腔镜手术逐步推荐成为胃癌外科治疗的手段之一,在全世界范围尤其是以日本、韩国及中国为代表的东亚地区广泛应用。单孔及减孔腹腔镜手术最早应用于胆囊、阑尾切除术,因其微创及美容效果佳,被胃肠外科医师所关注。其在胃癌外科的临床应用仍处于探索阶段。初期观察性临床研究结果显示,其在美容效果及加速康复外科方面与传统的五孔腹腔镜胃癌手术相比较,具有潜在的优势,但其手术安全性及可行性仍缺乏高级别循证医学证据的支持。
中图分类号:
燕速, 郑民华. 中国单孔及减孔腹腔镜胃癌手术实践[J]. 外科理论与实践, 2023, 28(03): 233-239.
YAN Su, ZHENG Minhua. Practice of single-port and reduced-port laparoscopic gastric cancer surgery in China[J]. Journal of Surgery Concepts & Practice, 2023, 28(03): 233-239.
[1] |
KYLE R A, STEENSMA D P. Christian Albert Theodor Billroth: founder of abdominal surgery[J]. Mayo Clin Proc, 2018, 93(3):e29-e30.
doi: 10.1016/j.mayocp.2017.06.026 URL |
[2] |
GOH P, TEKANT Y, KUM C K, et al. Totally intra-abdominal laparoscopic Billroth Ⅱ gastrectomy[J]. Surg Endosc, 1992, 6(3):160.
doi: 10.1007/BF02309093 URL |
[3] | KITANO S, ISO Y, MORIYAMA M, et al. Laparoscopy-assisted Billroth Ⅰ gastrectomy[J]. Laparosc Endosc, 1994, 4(2):146-148. |
[4] |
FUJIYA K, TOKUNAGA M, NISHIWAKI N, et al. Feasibility of laparoscopic distal gastrectomy for stage Ⅰ gastric cancer in patients outside of clinical trials[J]. Gastrointest Surg, 2018, 22(10):1665-1671.
doi: 10.1007/s11605-018-3842-6 |
[5] |
KATAI H, SASAKO M, FUKUDA H, et al. Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage Ⅰ gastric cancer: a multicenter phase Ⅱ trial (JCOG 0703)[J]. Gastric Cancer, 2010, 13(4):238-244.
doi: 10.1007/s10120-010-0565-0 URL |
[6] | KITANO S, SHIRAISHI N, UYAMA I, et al. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan[J]. N Surg, 2007, 245(1):68-72. |
[7] |
NAKAMURA K, KATAI H, MIZUSAWA J, et al. A phase Ⅲ study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage ⅠA/ⅠB gastric cancer(JCOG0912)[J]. Jpn J Clin Oncol, 2013, 43(3):324-327.
doi: 10.1093/jjco/hys220 URL |
[8] |
KIM W, KIM H H, HAN S U, et al. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage Ⅰ gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01)[J]. Ann Surg, 2016, 263(1):28-35.
doi: 10.1097/SLA.0000000000001346 URL |
[9] | HU Y, HUANG C, SUN Y, et al. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial[J]. Clin Oncol, 2016, 34(12):1350-1357. |
[10] |
YU J, HUANG C, SUN Y, et al. Effect of laparoscopic vs. open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer: the CLASS-01 randomized clinical trial[J]. JAMA, 2019, 321(20):1983-1992.
doi: 10.1001/jama.2019.5359 URL |
[11] |
LIU F L, HUANG C M, XU Z K, et al. Morbidity and mortality of laparoscopic vs. open total gastrectomy for clinical stage Ⅰ gastric cancer: the CLASS02 multicenter randomized clinical trial[J]. JAMA Oncol, 2020, 6(10):1590-1597.
doi: 10.1001/jamaoncol.2020.3152 URL |
[12] |
KIM H H, HAN S U, KIM M C, et al. Effect of laparoscopic distal gastrectomy vs. open distal gastrectomy on long-term survival among patients with stage Ⅰ gastric cancer: the KLASS-01 randomized clinical trial[J]. JAMA Oncol, 2019, 5(4):506-513.
doi: 10.1001/jamaoncol.2018.6727 URL |
[13] | HYUNG W J, YANG H K, PARK Y K, et al. Long-term outcomes of laparoscopic distal gastrectomy for locally advanced gastric cancer: the KLASS-02-RCT randomized clinical trial[J]. Clin Oncol, 2020, 38(28):3304-3313. |
[14] |
ETOH T, OHYAMA T, SAKURAMOTO S, et al. Five-year survival outcomes of laparoscopy-assisted vs. open distal gastrectomy for advanced gastric cancer: the JLSSG0901 randomized clinical trial[J]. JAMA Surg, 2023, 158(5):445-454.
doi: 10.1001/jamasurg.2023.0096 URL |
[15] |
WHEELESS C R Jr. An inexpensive laparoscopy system for female sterilization[J]. Am J Obstet Gynecol, 1975, 123(7):727-733.
doi: 10.1016/0002-9378(75)90496-2 URL |
[16] |
PODOLSKY E R, ROTTMAN S J, POBLETE H, et al. Single port access (SPA) cholecystectomy: a completely transumbilical approach[J]. J Laparoendosc Adv Surg Tech A, 2009, 19(2):219-222.
doi: 10.1089/lap.2008.0275 URL |
[17] |
INOUE H, TAKESHITA K, ENDO M. Single-port laparoscopy assisted appendectomy under local pneumoperitoneum condition[J]. Surg Endosc, 1994, 8(6):714-716.
doi: 10.1007/BF00678574 URL |
[18] |
OMORI T, OYAMA T, AKAMATSU H, et al. Transumbilical single-incision laparoscopic distal gastrectomy for early gastric cancer[J]. Surg Endosc, 2011, 25(7):2400-2404.
doi: 10.1007/s00464-010-1563-3 URL |
[19] | PARK D J, LEE J H, AHN S H, et al. Single-port laparoscopic distal gastrectomy with D1+β lymph node dissection for gastric cancers: report of 2 cases[J]. Surg Laparosc Endosc Percutan Tech, 2012:e214-e216. |
[20] |
AHN S H, SON S Y, JUNG D H, et al. Pure single-port laparoscopic distal gastrectomy for early gastric cancer: comparative study with multi-port laparoscopic distal gastrectomy[J]. J Am Coll Surg, 2014, 219(5):933-943.
doi: 10.1016/j.jamcollsurg.2014.07.009 URL |
[21] |
OMORI T, FUJIWARA Y, MOON J, et al. Comparison of single-incision and conventional multi-port laparoscopic distal gastrectomy with D2 lymph node dissection for gastric cancer: a propensity score-matched analysis[J]. Ann Surg Oncol, 2016, 23(Suppl 5):817-824.
doi: 10.1245/s10434-016-5485-8 URL |
[22] |
OMORI T, YAMAMOTO K, HARA H, et al. A rando-mized controlled trial of single-port versus multi-port laparoscopic distal gastrectomy for gastric cancer[J]. Surg Endosc, 2021, 35(8):4485-4493.
doi: 10.1007/s00464-020-07955-0 |
[23] | OZDEMIR B A, THOMAS R L, SOON Y. Single-port laparoscopic subtotal gastrectomy with D1α lymphadenectomy[J]. Surg Innov, 2011, 18(4):NP1-4. |
[24] |
KANG S H, CHO Y S, MIN S H, et al. Early experience and learning curve of solo single-incision distal gastrectomy for gastric cancer: a review of consecutive 100 cases[J]. Surg Endosc, 2019, 33(10):3412-3418.
doi: 10.1007/s00464-018-06638-1 |
[25] |
KUNISAKI C, ONO H A, OSHIMA T, et al. Relevance of reduced-port laparoscopic distal gastrectomy for gastric cancer: a pilot study[J]. Dig Surg, 2012, 29(3):261-268.
doi: 10.1159/000341677 URL |
[26] |
JEONG O, PARK Y K, RYU S Y. Early experience of duet laparoscopic distal gastrectomy (duet-LDG) using three abdominal ports for gastric carcinoma: surgical technique and comparison with conventional laparoscopic distal gastrectomy[J]. Surg Endosc, 2016, 30(8):3559-3566.
doi: 10.1007/s00464-015-4653-4 URL |
[27] |
KIM K H, LEE S H, CHOI C W, et al. Actual 3-year survival after reduced-port laparoscopic distal gastrectomy for gastric cancer (RpLDG): a propensity score matching analysis[J]. J Gastrointest Surg, 2022, 26(3):550-557.
doi: 10.1007/s11605-021-05097-9 |
[28] |
KUNISAKI C, MIYAMOTO H, SATO S, et al. Surgical outcomes of reduced-port laparoscopic gastrectomy versus conventional laparoscopic gastrectomy for gastric cancer: a propensity-matched retrospective cohort study[J]. Ann Surg Oncol, 2018, 25(12):3604-3612.
doi: 10.1245/s10434-018-6733-x |
[29] |
AHN S H, SON S Y, JUNG D H, et al. Solo intracorporeal esophagojejunostomy reconstruction using a laparoscopic scope holder in single-port laparoscopic total gastrectomy for early gastric cancer[J]. J Gastric Cancer, 2015, 15(2):132-138.
doi: 10.5230/jgc.2015.15.2.132 URL |
[30] | 郑民华, 马君俊. 单孔腹腔镜结肠癌根治术的规范化操作技术要点[J]. 中华腔镜外科杂志(电子版), 2017, 10(6):330-334. |
ZHENG M H, MA J J. Key technical points of standar-dized operation of single hole laparoscopic radical resection of colon cancer[J]. Chin J Lapar Surg (Electronic Edition), 2015, 15(2):132-138. | |
[31] | 郑民华, 张卓. 腹腔镜经脐单孔腹腔镜和NOTES应用现状与评价[J]. 中国实用外科杂志, 2009, 29(1):33-34. |
ZHENG M H, ZHANG Z. Application status and evaluation of transumbilical monopole laparoscopy and NOTES[J]. Chin J Pract Surg, 2009, 29(1):33-34. | |
[32] | 蒋奕玫, 李佑, 季晓频, 等. 经脐单孔腹腔镜直肠癌根治术可行性初步研究[J]. 中华胃肠外科杂志, 2015, 18(8):843-845. |
JIANG Y M, LI Y, JI X P, et al. Preliminary feasibility study of radical resection of rectal cancer through umbilical single-incision laparoscopic surgery[J]. Chin J Gastrointest Surg, 2015, 18(8):843-845. | |
[33] | 赵任, 蒋奕玫. 单孔腹腔镜结肠直肠癌根治术的现状[J]. 外科理论与实践, 2018, 23(5):398-401. |
ZHAO R, JIANG Y M. Current status of single-port laparoscopic radical resection of colorectal cancer[J]. J Surg Concepts Pract, 2018, 23(5):398-401. | |
[34] | 江志伟, 龚剑峰, 王刚, 等. 经脐单孔腹腔镜局部胃切除治疗胃间质瘤1例[J]. 中国实用外科志, 2010, 30(1):72-73. |
JIANG Z W, GONG J F, WANG G, et al. Treatment of gastric stromal tumor by transumbilical single- incision laparoscopic local gastrectomy: a case report[J]. Chin J Pract Surg, 2010, 30(1):72-73. | |
[35] | 吴硕东, 苏洋, 孔静, 等. 单切口腹腔镜全胃切除术一例[J]. 中华医学杂志, 2011, 91(18):1296-1296. |
WU S D, SU Y, KONG J, et al. One case of single incision laparoscopic total gastrectomy[J]. Natl Med J China, 2011, 91(18):1296-1296. | |
[36] |
LIN T, MOU T Y, HU Y F, et al. Reduced port laparoscopic distal gastrectomy with D2 lymphadenectomy[J]. Ann Surg Oncol, 2018, 25(1):246.
doi: 10.1245/s10434-017-6066-1 URL |
[37] |
TENG W H, LIU J F, LIU W J, et al. Short-term outcomes of reduced-port laparoscopic surgery versus conventional laparoscopic surgery for total gastrectomy: a single-institute experience[J]. BMC Surg, 2023, 23(1):75.
doi: 10.1186/s12893-023-01972-1 |
[38] | 燕速, 马新福, 赵康. 经脐小切口联合左上腹单孔腹腔镜远端胃癌根治术[J]. 中华普外科手术学杂志(电子版), 2019, 13(5):450. |
YAN S, MA X F, ZHAO K. Transumbilical single-incision plus one-port laparoscopic distal gastrectomy for advanced gastric cancer[J]. Chin J Oper Proce General Surg (Electronic Edition), 2019, 13(5):450. | |
[39] | 王淳, 燕速. 减孔腹腔镜胃癌根治术的现状及展望[J]. 临床医学研究与实践, 2021, 6(10):196-198. |
WANG C, YAN S. Current status and prospect of reduced port laparoscopic radical gastrectomy[J]. Clin Res Pract, 2021, 6(10):196-198. | |
[40] | 郑孝榕, 马玉滨, 燕速. 两孔腹腔镜胃癌根治术的临床安全性及可行性研究[J]. 腹腔镜外科杂志, 2022, 27(1):40-44. |
ZHENG X R, MA Y B, YAN S. Safety and feasibility of single-port with one trocar laparoscopic radical gastrectomy for gastric cancer[J]. J Lapar Surg, 2022, 27(1):40-44. |
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