切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 541 -543. doi: 10.3877/cma.j.issn.1674-3946.2020.06.001

所属专题: 述评/论坛 总编推荐 文献

专家述评

3D腹腔镜胃癌根治术的优势与发展
黄昌明1,(), 许斌斌1, 林密1   
  1. 1. 350001 福建福州,福建医科大学附属协和医院胃外科
  • 收稿日期:2020-06-18 出版日期:2020-12-26
  • 通信作者: 黄昌明

The advantages and development of 3D laparoscopic radical surgery for gastric cancer

Changming Huang1,(), Binbin Xu1, Mi Lin1   

  1. 1. Department of Gastrointestinal Surgery, Fujian Medical University Union Hospital
  • Received:2020-06-18 Published:2020-12-26
  • Corresponding author: Changming Huang
  • About author:
    Corresponding author: Huangchangming, Email:
  • Supported by:
    National Natural Science Foundation of China(81871899); Construction Project of Fujian Province Minimally Invasive Medical Center([2017]171); Project of Fujian provincial science and technology innovation joint funding plan(2018Y9005)
引用本文:

黄昌明, 许斌斌, 林密. 3D腹腔镜胃癌根治术的优势与发展[J/OL]. 中华普外科手术学杂志(电子版), 2020, 14(06): 541-543.

Changming Huang, Binbin Xu, Mi Lin. The advantages and development of 3D laparoscopic radical surgery for gastric cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(06): 541-543.

腹腔镜辅助胃癌根治术自问世以来,便以其微创优势而迅速普及,但腹腔镜显像系统仅提供一个2D的手术视野,腹腔镜下手术操作难度大,且学习曲线较长。3D腹腔镜系统是近年来新兴的腹腔镜技术平台,其通过构建景深及三维立体结构,提供了真实视觉中的立体手术视野,为手术操作提供了较为精准的空间定位。在胃癌根治术中,3D腹腔镜系统有利于胃周血管裸化、淋巴结清扫,减少术中出血量,亦可能缩短初学者的学习曲线。但是,术者佩戴的偏振式眼镜使得图像分辨率降低,且目前尚缺乏该术式远期肿瘤学疗效的相关证据。未来,3D腹腔镜胃癌根治术的进一步发展仍需要更多高级别循证医学证据。

Since the advent of laparoscopic assisted radical gastrectomy for gastric cancer, it has been rapidly popularized due to its own minimally invasive advantages. However, the conventional laparoscopic imaging system could only provides a two-dimensional (2D) surgical vision, which makes it hard to delicately operate with a longer learning curve. Three-dimensional (3D) laparoscopic imaging system is a newly developed technology platform recently. It could provide a stereoscopic surgical field of vision in real vision by constructing a depth of field and a 3D structure, and could provide more accurate spatial positioning for surgical operations. In radical gastrectomy, the 3D laparoscopic system is conducive to dissect stomach blood vessels with better lymph node dissection and less intraoperative bleeding, and might shorten the learning curve for beginners. However, the polarized glasses worn by the surgeons might reduce the image resolution. In addition, currently there was no evidence about the long-term oncological efficacy of the 3D radical gastrectomy. The further development of 3D laparoscopic radical gastrectomy for gastric cancer in the future requires more high-level evidence.

图1 3D腹腔镜下幽门下区域淋巴结清扫后
图2 3D腹腔镜下胰腺上缘区域淋巴结清扫后
图3 3D腹腔镜下脾门区域淋巴结清扫后
[1]
Fock KM. Review article: the epidemiology and prevention of gastric cancer[J]. Aliment Pharmacol Ther, 2014, 40(3): 250-260.
[2]
Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy[J]. Surg Laparosc Endosc, 1994, 4(2): 146-148.
[3]
Hu YF, Huang CM, Sun YH, et al. Morbidity and Mortality of Laparoscopic Versus Open D2 Distal Gastrectomy for Advanced Gastric Cancer: A Randomized Controlled Trial[J]. J Clin Oncol, 2016, 34(12): 1350-1357.
[4]
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.
[5]
Zheng CH, Lu J, Zheng HL, et al. Comparison of 3D laparoscopic gastrectomy with a 2D procedure for gastric cancer: A phase 3 randomized controlled trial[J]. Surgery, 2018, 163(2): 300-304.
[6]
季福建,房学东.3D腹腔镜与2D腹腔镜胃癌根治术临床疗效及学习曲线对比研究[J].临床与病理杂志,2015, 0 (z1): 36.
[7]
Buess G, Theiss R, Gunther M, et al. Endoscopic surgery in the rectum[J]. Endoscopy, 1985, 17(1): 31-35.
[8]
Hanna GB, Shini SM, Cuschieri A. Randomised study of influence of two-dimensional versus three-dimensional imaging on performance of laparoscopic cholecystectomy[J].Lancet,1998, 351(9098): 248-251.
[9]
Von Pichler C, Radermacher K, Boeckmann W, et al. Three-dimensional versus two-dimensional video endoscopy. A clinical field study in laparoscopic application[J]. Stud Health Technol Inform, 1996, 29: 667-674.
[10]
Game X, Binhazzaa M, Soulie M, et al. Three-dimensional laparoscopy for living-donor nephrectomy with vaginal extraction: The first case[J]. Int J Surg Case Rep, 2017, 34: 87-89.
[11]
Velayuthan V, Fuks D, Nomi T, et al. 3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study[J]. Surgical Endoscopy, 2015, 30(1): 147-153.
[12]
郑民华,马君俊,蔡正昊,等.3D腹腔镜手术技术中国专家共识(2019版)[J].中国实用外科杂志,2019, 39 (11): 1136-1141.
[13]
Liu ZY, Chen QY, Zhong Q, et al. Is three-dimensional laparoscopic spleen preserving splenic hilar lymphadenectomy for gastric cancer better than that of two-dimensional? Analysis of a prospective clinical research study[J]. Surg Endosc, 2019, 33(10): 3425-3435.
[14]
Wilhelm D, Reiser S, Kohn N, et al. Comparative evaluation of HD 2D/3D laparoscopic monitors and benchmarking to a theoretically ideal 3D pseudodisplay: even well-experienced laparoscopists perform better with 3D[J]. Surg Endosc, 2014, 28(8): 2387-2397.
[15]
郑民华,马君俊.微创外科相关科技创新热点及其在胃肠外科中的应用[J].中华消化外科杂志,2019, 18(5): 419-422.
[1] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[2] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[3] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[4] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[5] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[6] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[7] 刘世君, 马杰, 师鲁静. 胃癌完整系膜切除术+标准D2根治术治疗进展期胃癌的近中期随访研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 27-30.
[8] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[9] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[10] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[11] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[12] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
[13] 郭兵, 王万里, 何凯, 黄汉生. 腹腔镜下肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 143-143.
[14] 李凯, 陈淋, 苏怀东, 向涵, 张伟. 超微创器械在改良单孔腹腔镜巨大肝囊肿开窗引流及胆囊切除中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 144-144.
[15] 魏丽霞, 张安澜, 周宝勇, 李明. 腹腔镜下Ⅲb型肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 145-145.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?