CAJ | 학술논문

腹腔镜手术的优势及其可行性已达成共识。对于中国这个以进展期患者为主的胃癌大国，现阶段如何合理地推广腹腔镜手术，是目前胃癌临床工作面临的主要问题之一。对于早期胃癌，腹腔镜手术是标准治疗方法之一，但外科医生也应熟识并严格把握早期胃癌内镜治疗适应证，避免过度治疗。对于进展期胃癌，腹腔镜手术治疗目前仍缺乏循证医学证据，应在临床试验的背景下进行。虽然国内腹腔镜胃癌手术开展之势迅猛，但相应的培训、准入及监督机制尚未充分建立。在将患者利益放在首位的基础上，如何应对学习曲线阶段和进展期胃癌的腹腔镜手术适应证，是我们迫切需要思考和解决的问题。
복강경수술적우세급기가행성이체성공식。대우중국저개이진전기환자위주적위암대국，현계단여하합리지추엄복강경수술，시목전위암림상공작면림적주요문제지일。대우조기위암，복강경수술시표준치료방법지일，단외과의생야응숙식병엄격파악조기위암내경치료괄응증，피면과도치료。대우진전기위암，복강경수술치료목전잉결핍순증의학증거，응재림상시험적배경하진행。수연국내복강경위암수술개전지세신맹，단상응적배훈、준입급감독궤제상미충분건립。재장환자이익방재수위적기출상，여하응대학습곡선계단화진전기위암적복강경수술괄응증，시아문박절수요사고화해결적문제。
Consensus has been reached on the advantage and validity of laparoscopic surgery , but how to extend the usage of laparoscopic surgery in gastric cancer properly in China remains a problem as advanced gastric cancer occupies the majority of patients here. In the treatment of early gastric cancer, laparoscopic surgery nowadays is one of the standard treatments but surgeons still need to follow the indication of surgery strictly to avoid the excessive treatment in patients who are indicated for endoscopic therapy. There is still lack of evidence on the application of laparoscopic surgery in the treatment of advanced gastric cancer, therefore these procedures should be performed in the context of clinical trials. With the development of laparoscopic surgery in the treatment of advanced gastric cancer, training, certification and supervision systems are still not established. More attention should be paid to the choice of patients during the early period of learning curves and the indication of advanced stage.