早期胃癌的腹腔镜治疗

胃癌是我国最常见的恶性肿瘤之一，其早期诊断和治疔是提高疗效的关键。早期胃癌是指病变仅限于黏膜及黏膜下层，而不论病变的范用和有无淋巴结转移，早期胃癌术后5年生存率可达94％～96％。1994年日本Kitano报道了首例腹腔镜辅助远端胃切除术治疗早期胃癌，经过10余年的发展，腹腔镜手术在早期胃癌治疗上已经成熟，它与开腹手术近、远期疗效相当，2004年日本胃癌协会将腹腔镜胃癌根治术作为IA期胃癌的标准治疗方案之一。本文重点介绍以下3个方面：①早期胃癌腹腔镜治疗的术式和适应证；②早期胃癌腹腔镜治疗的安全性和根治性评价；③我国早期胃癌腹腔镜治疗的现状和展望。

Laparoscopic surgery for early gastric cancer

Gastric cancer, one of the most common malignant tumors in China, whose diagnosis and treatment in early stage could be the key point to improve the curative effect. Early gastric cancer is defined as adenocarcinoma that is limited to the gastric mucosa or submucosa regardless of whether regional lymph nodes are involved or not. This definition reflects a 94% -96% of 5-year survival rate. The first laparoscopic assisted distal gastrectomy（LADG） was reported in 1994. Nowadays, laparoseopic radical gastrectomy can almost gain the same effect as laparotomy after ten-year evolution. In 2004, the Japanese Gastric Cancer Association had defined laparoscopic radical gastrectomy as one of the standard operative treatment of stage IA gastric cancer. The key points of this article are the operative pattern and indication of laparoscopic radical gastrectomy of early gastric cancer, the safety and radical effect of this procedure, and the current situation and expectation of this operation in China.