老年进展期胃癌的外科治疗

胃癌是我国死亡率最高的恶性肿瘤之一,随着人口老龄化,老年患者逐渐增多。根治性手术是治愈进展期胃癌的唯一手段:D2胃癌根治术作为治疗进展期胃癌的标准术式已被普遍接受。几项临床试验已证实与D2根治术相比,扩大手术范围并未使患者术后生存率有更多的获益。为改善进展期胃癌患者的预后,必须强调开展术前TNM分期,以便临床医师根据肿瘤的状况选择合适的治疗方案。微创外科技术在进展期胃癌中的应用仍有争议,需要进一步研究。胃癌术后消化道重建方式是决定术后生活质量的关键因素,理想的重建方式仍有争议。

Surgical treatment of old patients with advanced gastric cancer

Gastric cancer remains the most common causes of cancer-related death in China. With aging of population, elderly patients gradually increased. Radical operation is the only potentially curative therapy for advanced gastric cancer（AGC）. D2 radical gastrectomy has been widely accepted as a standard surgical procedure for patients with AGC in China. Several clinical trials have revealed that more extended resection than D2 surgery has no impact on survival. In order to improve the prognosis of AGC patients, it is necessary to carry out the preoperative TNM staging for selecting a reasonable therapeutical modality before surgery. Application of minimally invasive surgical techniques in advanced gastric cancer is still controversial, which need further research. Postoperative gastric cancer of digestive tract reconstruction is a key factor in the quality of postoperative life, the ideal mode of reconstruction is still a controversial issue.