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) ›› 2021, Vol. 15 ›› Issue (02) : 133 -138. doi: 10.3877/cma.j.issn.1674-3946.2021.02.004

所属专题: 述评/论坛 总编推荐 文献

专家论坛

腹腔镜胃癌术后主要并发症防治策略
李子禹1,(), 吴舟桥1, 王一丁1, 季加孚1   
  1. 1. 100142 北京大学肿瘤医院胃肠肿瘤中心一病区
  • 收稿日期:2020-09-13 出版日期:2021-04-26
  • 通信作者: 李子禹

Prevention and intervention strategies for complications after laparoscopic gastric cancer surgery

Ziyu Li1,(), Zhouqiao Wu1, Yiding Wang1, Jiafu Ji1   

  1. 1. Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China
  • Received:2020-09-13 Published:2021-04-26
  • Corresponding author: Ziyu Li
  • Supported by:
    Beijing Hospitals Authority 'Dengfeng’ Talent Training Plan(DFL20181103); Beijing Municipal Administration of Hospitals'Youth Program(QML20191103)
引用本文:

李子禹, 吴舟桥, 王一丁, 季加孚. 腹腔镜胃癌术后主要并发症防治策略[J/OL]. 中华普外科手术学杂志(电子版), 2021, 15(02): 133-138.

Ziyu Li, Zhouqiao Wu, Yiding Wang, Jiafu Ji. Prevention and intervention strategies for complications after laparoscopic gastric cancer surgery[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(02): 133-138.

腹腔镜作为一项日益成熟、蓬勃发展的微创技术,由于其侵袭性小,利于患者康复等优点,已经广泛应用于胃癌临床诊治中并取得了良好的近远期疗效。然而,胃癌术后并发症仍是影响患者术后生活质量以及围手术期死亡的重要原因,自然也是腹腔镜手术关注的重点。笔者通过腹腔镜胃癌手术相关临床研究及数据库,结合团队临床经验,系统阐述近年来腹腔镜胃癌手术术后并发症的防治要点。

Laparoscopic surgery was vigorously developed and clinically implemented to minimize surgical invasion and facilitate patient recovery, which has extensively applied in gastric cancer treatment. However, postoperative complications of gastric cancer are still an important reason affecting perioperative quality of life and perioperative death of patients which is naturally the focus of laparoscopic surgery as well. Based on clinical studies and databases related to laparoscopic gastric cancer surgery, combined with the clinical experience of our team, this review systematically summarizes the prevention and treatment of complications after laparoscopic gastric cancer surgery in recent years accordingly.

[1]
Kitano S, Iso Y, Moriyama M, et al.Laparoscopy-assisted Billroth I gastrectomy[J]. Surg Laparosc Endosc, 1994, 4(2): 146-148.
[2]
中国临床肿瘤学会指南工作委员会.中国临床肿瘤学会(CSCO)胃癌诊疗指南(2019)[M].北京:人民卫生出版社,2019.
[3]
日本胃癌学会.胃癌治疗指南[M].第5版.东京:金原出版株式会社.
[4]
National comprehensive Cancer Network, NCCN Clinical Practice Guidelines in Oncology(NCCN Guidelines )[EB/OL]. Gastric Cancer, Version 3, 2019.
[5]
季加孚.胃癌腹腔镜外科的中国标准和里程碑--评述《腹腔镜局部进展期远端胃癌D2根治术标准操作流程:CLASS 01研究共识》的发布[J]. 中华胃肠外科杂志,2019,22(10):913-915.
[6]
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.
[7]
Vinuela EF, Gonen M, Brennan MF, et al.Laparoscopic versus open distal gastrectomy for gastric cancer: a meta-analysis of randomized controlled trials and high-quality nonrandomized studies[J]. Ann Surg, 2012, 255(3): 446-456.
[8]
Lee H-J, Hyung WJ, Yang H-K, et al.Short-term outcomes of a multicenter randomized controlled trial comparing laparoscopic distal gastrectomy with D2 lymphadenectomy to open distal gastrectomy for locally advanced gastric cancer (KLASS-02-RCT) [J]. Ann Surg, 2019, 270(6): 983-991.
[9]
Best LM, Mughal M, Gurusamy KS.Laparoscopic versus open gastrectomy for gastric cancer[J]. Cochrane Database Syst Rev, 2016, 3(3): CD011389.
[10]
吴舟桥,李子禹,季加孚.中国胃肠肿瘤外科联盟数据库建设及对胃肠外科诊疗的推动作用[J]. 中华胃肠外科杂志,2020,23(1): 26-32.
[11]
王琦,吴舟桥,侯士阳,等.胃结直肠癌术后腹腔感染性并发症的现状研究(PACAGE研究) [J].中华消化外科杂志,2019,18(3):229-234.
[12]
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]. J Clin Oncol, 2016, 34(12): 1350-1357.
[13]
Hyung WJ, 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]. J Clin Oncol, 2020, 38(28): 3304-3313.
[14]
Kakeji Y, Yamamoto H, Ueno H, et al.Development of gastroenterological surgery over the last decade in Japan: analysis of the National Clinical Database[J]. Surg Today, 2020.Online ahead of print.
[15]
Kurita N, Miyata H, Gotoh M, et al.Risk Model for Distal Gastrectomy When Treating Gastric Cancer on the Basis of Data From 33, 917 Japanese Patients Collected Using a Nationwide Web-based Data Entry System[J]. Ann Surg, 2015, 262(2): 295-303.
[16]
Watanabe M, Miyata H, Gotoh M, et al.Total gastrectomy risk model: data from 20, 011 Japanese patients in a nationwide internet-based database[J]. Ann Surg, 2014, 260(6): 1034-1039.
[17]
Liu FL, Huang CM, Xu ZK, 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.
[18]
李双喜,吴晓江,张连海,等,腹腔镜辅助胃癌根治手术学习曲线的初步探讨[J].2011,3(3):156-159.
[19]
Krarup P-M, Nordholm-Carstensen A, Jorgensen LN, et al.Anastomotic leak increases distant recurrence and long-term mortality after curative resection for colonic cancer: a nationwide cohort study[J]. Ann Surg, 2014, 259(5): 930-938.
[20]
Tokunaga M, Tanizawa Y, Bando E, et al.Oncology, Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer[J]. Ann Surg Oncol, 2013, 20(5): 1575-1583.
[21]
Sugisawa N, Tokunaga M, Tanizawa Y, et al.Intra-abdominal infectious complications following gastrectomy in patients with excessive visceral fat[J]. Gastric Cancer, 2012, 15(2): 206-212.
[22]
Alonso S, Pascual M, Salvans S, et al.Postoperative intra-abdominal infection and colorectal cancer recurrence: A prospective matched cohort study of inflammatory and angiogenic responses as mechanisms involved in this association[J]. Eur J Surg Oncol, 2015, 41(2): 208-214.
[23]
徐泽宽,徐皓,王林俊,全腹腔镜胃癌根治术消化道重建方式的选择及技术要点[J]. 中华消化外科杂志,2017,16(3):227-230.
[24]
Abou Rached A, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: review of its prevention and management[J]. World J Gastroenterol, 2014, 20(38): 13904-13910.
[25]
中华医学会外科学分会胃肠外科学组,中华医学会外科学分会腹腔镜与内镜外科学组,中国抗癌协会胃癌专业委员会.完全腹腔镜胃癌手术消化道重建专家共识及手术操作指南(2018版)[J]. 中国实用外科杂志,2018,38(8):833-839.
[26]
石晋瑶,吴舟桥,李子禹,等.引流液异常对胃肠肿瘤术后腹盆腔感染性并发症的早期预测作用[J].国际外科学杂志,2018,45(4):233-238.
[27]
Lee S, Ahn JY, Na S, et al.Clinical features of postoperative anastomotic bleeding after gastrectomy and efficacy of endoscopic hemostasis: a case-control study[J]. Surg Endosc, 2017, 31(8): 3210-3218.
[28]
Ryu KW, Kim YW, Lee JH, et al.Surgical complications and the risk factors of laparoscopy-assisted distal gastrectomy in early gastric cancer[J]. Ann Surg Oncol, 2008, 15(6): 1625-1631.
[29]
Miao RL, Qu JJ, Li ZR, et al.Anatomical variation of infra-pyloric artery origination: A prospective multicenter observational study (IPA-Origin) [J]. Chin J Cancer Res, 2018, 30(5): 500-507.
[30]
Li ZY, Shan F, Ying XJ, et al.Assessment of Laparoscopic Distal Gastrectomy After Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Randomized Clinical Trial[J]. JAMA Surg, 2019, 154(12): 1093-1101.
[31]
中国医师协会外科医师分会,中国医师协会外科医师分会肿瘤外科医师委员会,中国医师协会外科医师分会多学科综合治疗专业委员会.恶性肿瘤相关急腹症多学科管理中国专家共识[J]. 中华胃肠外科杂志,2020,23(5):421-437.
[32]
Park JY, Kim Y-W, Eom BW, et al.Unique patterns and proper management of postgastrectomy bleeding in patients with gastric cancer[J]. Surgery, 2014, 155(6): 1023-1029.
[33]
Kitano S, Shiraishi N, Uyama I, et al.A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan[J]. Ann Surg, 2007, 245(1): 68-72.
[34]
Park DJ, Lee H-J, Kim H-H, et al.Predictors of operative morbidity and mortality in gastric cancer surgery[J]. Br J Surg, 2005, 92(9): 1099-1102.
[35]
Kim MC, Kim W, Kim HH, et al.Risk Factors Associated with Complication Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Large-Scale Korean Multicenter Study[J]. Ann Surg Oncol, 2008, 15(10): 2692-2700.
[36]
Kodera Y, Sasako M, Yamamoto S, et al.Identification of risk factors for the development of complications following extended and superextended lymphadenectomies for gastric cancer[J]. Br J Surg, 2005, 92(9): 1103-1109.
[37]
Morita K, Maeda N, Kawaoka T, et al.Effects of the time interval between clamping and linear stapling for resection of porcine small intestine[J]. Surg Endosc, 2008, 22(3): 750-756.
[38]
中国医师协会急诊医师分会.急性上消化道出血急诊诊治流程专家共识[J].中国急救医学,2015,35(10):865-873.
[39]
中国胃肠外科联盟,中国抗癌协会胃癌专业委员会.中国胃肠肿瘤外科术后并发症诊断登记规范专家共识(2018版) [J]. 中国实用外科杂志,2018,38(6):589-595.
[40]
中华医学会外科学分会胰腺外科学组,中国研究型医院学会胰腺病专业委员会,中华外科杂志编辑部.胰腺术后外科常见并发症诊治及预防的专家共识(2017) [J]. 中华外科杂志,2017,55(5):328-334.
[41]
施思,项金峰.徐近,等.2016版国际胰腺外科研究组术后胰瘘定义和分级系统更新内容介绍和解析[J].中国实用外科杂志,2017,(2):149-152.
[42]
Kamiya S, Hiki N, Kumagai K, et al. Two-point measurement of amylase in drainage fluid predicts severe postoperative pancreatic fistula after gastric cancer surgery[J]. Gastric Cancer, 2018, 21(5): 871-878.
[43]
陈伟东,刘凤林,沈振斌,等.胃癌D2根治术后胰漏及其相关因素分析[J]. 中华胃肠外科杂志,2010,13(6):421-423.
[44]
Hiki N, Honda M, Etoh T, et al.Higher incidence of pancreatic fistula in laparoscopic gastrectomy. Real-world evidence from a nationwide prospective cohort study[J]. Gastric Cancer, 2018, 21(1): 162-170.
[45]
Huang C-M, Tu R-H, Lin J-X, et al.A scoring system to predict the risk of postoperative complications after laparoscopic gastrectomy for gastric cancer based on a large-scale retrospective study[J]. Medicine, 2015, 94(17): e812.
[46]
Adachi Y, Shiraishi N, Shiromizu A, et al.Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy[J]. Arch Surg, 2000, 135(7): 806-810.
[47]
Yasunaga H, Horiguchi H, Kuwabara K, et al.Outcomes after laparoscopic or open distal gastrectomy for early-stage gastric cancer: a propensity-matched analysis[J] Ann Surg, 2013, 257(4): 640-646.
[48]
Kang SH, Lee Y, Min S-H, et al.Multimodal Enhanced Recovery After Surgery (ERAS) Program is the Optimal Perioperative Care in Patients Undergoing Totally Laparoscopic Distal Gastrectomy for Gastric Cancer: A Prospective, Randomized, Clinical Trial[J]. Ann Surg Oncol, 2018, 25(11): 3231-3238.
[49]
Hayashi S, Fujii M, Takayama T. Prevention of postoperative small bowel obstruction in gastric cancer[J]. Surg Today, 2015, 45(11): 1352-1359.
[50]
Fukagawa T, Gotoda T, Oda I, et al.Stenosis of esophago-jejuno anastomosis after gastric surgery[J]. World J Surg, 2010, 34(8): 1859-1863.
[51]
Kim CG, Choi IJ, Lee JY, et al.Effective diameter of balloon dilation for benign esophagojejunal anastomotic stricture after total gastrectomy[J]. Surg Endosc, 2009, 23(8): 1775-1780.
[52]
Zuiki T, Hosoya Y, Kaneda Y, et al.Stenosis after use of the double-stapling technique for reconstruction after laparoscopy-assisted total gastrectomy[J]. Surg Endosc, 2013, 27(10): 3683-3689.
[53]
Shim JH, Yoo HM, Oh SI, et al.Various types of intracorporeal esophagojejunostomy after laparoscopic total gastrectomy for gastric cancer[J]. Gastric Cancer, 2013, 16(3): 420-427.
[54]
Fringeli Y, Worreth M, Langer I. Gastrojejunal anastomosis complications and their management after laparoscopic Roux-en-Y gastric bypass[J]. J Obes, 2015, 2015: 698425.
[55]
Chang H-M, Lee S-W, Eiji N, et al.Laparoscopic versus open gastrectomy for gastric cancer patients with COPD[J]. J Surg Oncol, 2009, 100(6): 456-458.
[56]
Park JC, Choi YS, Park SH. Massive Subcutaneous Emphysema and Uncontrolled Hypercarbia during Laparoscopic Assisted Distal Gastrectomy: A case report[J]. Korean J Anesthesiol, 2007, 53(3): 382-386.
[57]
Lee J-H, Park DJ, Kim H-H, et al.Comparison of complications after laparoscopy-assisted distal gastrectomy and open distal gastrectomy for gastric cancer using the Clavien-Dindo classification[J]. Surg Endosc, 2012, 26(5): 1287-1295.
[58]
任广辉,李俊生.腹腔镜术后Trocar部位疝发生的原因及预防[J/CD]. 中华疝和腹壁外科杂志(电子版),2012,6(2):666-669.
[1] 安杰, 牛云峰, 刘伟. LINC00520 通过miR-519b-3p/HIF1A 轴促进胃癌的侵袭转移[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 430-436.
[2] 王振宁, 杨康, 王得晨, 邹敏, 归明彬, 王雅楠, 徐明. 机器人与腹腔镜手术联合经自然腔道取标本对中低位直肠癌患者远期疗效比较[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 437-442.
[3] 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.
[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] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[10] 常小伟, 蔡瑜, 赵志勇, 张伟. 高强度聚焦超声消融术联合肝动脉化疗栓塞术治疗原发性肝细胞癌的效果及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 56-59.
[11] 王露, 周丽君. 全腹腔镜下远端胃大部切除不同吻合方式对胃癌患者胃功能恢复、并发症发生率的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 92-95.
[12] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[13] 康婵娟, 张海涛, 翟静洁. 胰管支架置入术治疗急性胆源性胰腺炎的效果及对患者肝功能、炎症因子水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 667-670.
[14] 贺斌, 马晋峰. 胃癌脾门淋巴结转移危险因素[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 694-699.
[15] 付成旺, 杨大刚, 王榕, 李福堂. 营养与炎症指标在可切除胰腺癌中的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 704-708.
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?