Significant progress has been made in the surgical management of gastric cancer over the years, and previous discrepancies in surgical practice between different parts of the world have gradually lessened. A transition from the earlier period of progressively more extensive surgery to the current trend of a more tailored and evidence-based approach is clear. Prophylactic resection of adjacent anatomical structures or neighboring organs and extensive lymph node dissections that were once assumed to increase the chances of long-term survival are now performed selectively. Laparoscopic gastrectomy has been widely adopted and its indications have steadily expanded, from early cancers located in the distal part of the stomach, to locally advanced tumors where total gastrectomy is required. In parallel, function-preserving surgery has also evolved and now constitutes a valid option for early gastric cancer. Pylorus-preserving and proximal gastrectomy have improved the postoperative quality of life of patients, and sentinel node navigation surgery is being explored as the next step in the process of further refining the minimally invasive concept. Moreover, innovative techniques such as indocyanine green fluorescence imaging and robot-assisted gastrectomy are being introduced in clinical practice. These technologies hold promise for enhancing surgical precision, ultimately improving the oncological and functional outcomes.
多年来，胃癌的外科治疗取得了显著进展，全球不同地区在外科实践上的差异已逐渐缩小。从早期追求手术范围不断扩大，到当前更趋个体化、循证化的治疗策略，这一转变趋势已十分明确。过去认为可提高长期生存率的邻近解剖结构或器官预防性切除及广泛淋巴结清扫术，现已转为选择性实施。腹腔镜胃癌切除术已得到广泛应用，其适应症从局限于胃远端的早期癌逐步扩展至需行全胃切除的局部进展期肿瘤。与此同时，保功能手术也得到长足发展，现已成为早期胃癌的有效治疗选择。保留幽门的胃切除术和近端胃切除术改善了患者术后生活质量，而前哨淋巴结导航手术作为进一步深化微创理念的新方向正在积极探索中。此外，吲哚菁绿荧光成像、机器人辅助胃癌切除术等创新技术正逐步应用于临床。这些技术有望提升手术精准度，最终改善肿瘤学疗效与功能预后。
肿瘤(癌症)患者之家