中国实用外科杂志2025，Vol.45Issue(7)：753-758,6.DOI:10.19538/j.cjps.issn1005-2208.2025.07.04
新辅助治疗对胃癌手术精细解剖及质量控制的影响
The impact of neoadjuvant therapy on precise dissection and quality control in gastric cancer surgery
摘要
Abstract
Although neoadjuvant therapy significantly im-proves tumor control rates and pathological complete response(pCR)rates,the tissue edema and fibrosis it induces obscure the anatomical planes of the gastric mesentery,thereby increas-ing surgical complexity and complication risks(e.g.,increased intraoperative blood loss and prolonged operation time).The tissue alterations primarily manifest as:(1)Edema causing dif-ficulties in identifying anatomical planes,obvious exudation in the surgical area,and tissues being prone to tearing.(2)Fibro-sis leading to the disappearance of anatomical spaces,making dissection difficult and increasing the risk of collateral dam-age.To address these challenges,the following surgical quality control strategies are recommended:(1)Precise clinical stag-ing to avoid overtreatment.(2)Prudent implementation of func-tion-preserving surgery.Standard gastrectomy with D2 lymph-adenectomy should still be adhered to currently.Exploration of reduced or omitted surgery should only be considered for spe-cific patient groups.(3)Prioritize dissection of normal tissue ar-eas,avoid entering incorrect anatomical planes,employ suc-tion devices for assistance,and enhance team collaboration.Future efforts should focus on establishing an intraoperative tissue alteration evaluation system,advancing multimodal pre-cision staging,exploring pathways for function-preserving sur-gery in clinical research,and optimizing perioperative treat-ment through multidisciplinary collaboration.关键词
胃癌/新辅助治疗/组织改变/手术质量控制Key words
gastric cancer/neoadjuvant therapy/tissue alteration/surgical quality control分类
医药卫生引用本文复制引用
李子禹,邢继尧..新辅助治疗对胃癌手术精细解剖及质量控制的影响[J].中国实用外科杂志,2025,45(7):753-758,6.基金项目
科技部重点研发计划青年计划项目(No.2023YFC2415200) （No.2023YFC2415200）
北京市属医学科研院所公益发展改革试点项目(No.JYY2023-3) （No.JYY2023-3）
北京大学肿瘤医院科学研究基金项目(No.PY202335) National Key R&D Program of China(No.2023YFC2415200) （No.PY202335）
Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(PWD&RPP-MRI)(No.JYY2023-3) （PWD&RPP-MRI）
Science Foundation of Peking University Cancer Hospital(No.PY202335) （No.PY202335）
