中国实用外科杂志2025，Vol.45Issue(7)：759-762,4.DOI:10.19538/j.cjps.issn1005-2208.2025.07.05
精细解剖学对胃癌手术迷走神经保护的意义及操作要点分析
Vagus nerve preservation in gastric cancer surgery:significance and analysis of key operative techniques based on meticulous anatomy
摘要
Abstract
The precise dissection of the vagus nerve has become a critical element in the technical chain of function-preserving gastrectomy(FPG).At the technical level,innovations such as intraoperative nerve monitoring combined with navigation by indocyanine green fluorescence,optimization of surgical approaches,robotic surgical systems,and artificial intelligence(AI)-assisted surgical planning and navigation systems have significantly enhanced the precision and feasibility of vagus nerve preservation.However,controversies persist:while preservation of the hepatic branch has become a consensus,preservation of the celiac branch still requires more high-quality evidences due to its technical difficulty and potential impact on the thoroughness of lymph node dissection.Future research directions include:determining the safety of implementing nerve-preserving,reduced surgery or even exempt from surgery in patients achieving significant downstaging after neoadjuvant therapy,as well as evaluating the oncological safety of nerve preservation in advanced gastric cancer.In conclusion,precise vagus nerve preservation is crucial for improving the postoperative quality of life of gastric cancer patients.Advancing personalized and precision surgery requires the continued integration of technological progress combined with evidence-based medicine.关键词
胃癌/功能保留性胃切除术/迷走神经/精细解剖学Key words
gastric cancer/function preserving gastrectomy/vagus nerve/meticulous anatomy分类
医药卫生引用本文复制引用
张子臻,曹晖..精细解剖学对胃癌手术迷走神经保护的意义及操作要点分析[J].中国实用外科杂志,2025,45(7):759-762,4.基金项目
国家自然科学基金项目(No.82103510,No.82303428,No.82473077,No.82473065) （No.82103510,No.82303428,No.82473077,No.82473065）
癌症系统医学国家重点实验室项目(No.KF2205-93) （No.KF2205-93）
上海市教育委员会"人工智能促进科研范式赋能学科跃升计划"项目(No.JWAIZD-6) （No.JWAIZD-6）
上海市卫生健康委员会医学新技术研究与转化种子计划项目(No.2024ZZ2020) National Natural Science Foundation of China(No.82103510,No.82303428,No.82473077,No.82473065) （No.2024ZZ2020）
State Key Laboratory of Systems Medicine for Cancer(No.KF2205-93) （No.KF2205-93）
Shanghai Municipal Education Commission(No.JWAIZD-6) （No.JWAIZD-6）
Shanghai Municipal Health Commission(No.2024ZZ2020) （No.2024ZZ2020）
