胃癌外科综合治疗的若干进展与展望

胃癌是国内、外常见恶性肿瘤，手术仍是治疗胃癌的主要方法。一系列临床研究改变了传统胃癌手术理念，避免盲目扩大手术切除范围。腹腔镜手术治疗早期和局部进展期胃癌的疗效并不劣于开腹手术。胃癌微创手术发展的关键是把握合理的手术指征，建立手术技术培训系统，以及优化成本与效益。理性认识胃癌扩大术脏器切除与保留脏器功能的关系。注重局部进展期胃癌围术期治疗的全程管理。并提倡晚期胃癌的术前转化治疗。对广泛转移晚期胃癌的姑息性切除术应慎之又慎，建议综合治疗，旨在延长病人生命。

Progress and prospect of surgical comprehensive treatment of gastric cancer

Gastric cancer is one of the leading malignancies in China and in the world. Surgery is still the most important modality to cure gastric cancer. A series of clinical researches changed the traditional concept of surgery and avoided blindly expanding the scope of surgery. Laparoscopic surgery for both early and locally advanced gastric cancer achieved the same radical effect as open surgery. The key to further improve the efficacy of minimally invasive surgery is controlling indications, establishing a training system for surgical techniques and optimizing the relation between costs and benefits. The relationship between resection of organs and preservation of organ function should be balanced in the extended surgery for gastric cancer. Perioperative treatment of locally advanced gastric cancer would be advocated actively. Conversion therapy preoperatively for far-advanced gastric cancer is advocated. Palliative resection should be strictly controlled for the patients of far-advanced gastric cancer with extensive metastasis, and comprehensive treatment should be carried to prolong the life of patients.