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Minimally invasive surgery for gastric cancer in UK: current status and future perspectives

机译:英国胃癌微创手术的现状和未来展望

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摘要

The aim of this study is to review the literature and report the various minimally invasive methods used to treat gastric cancer in the UK and compare it with worldwide practice. Published randomised studies, non-randomised studies and case series reporting the use of minimal invasive approach to treat gastric cancer were retrieved from the search of standard medical electronic databases and their outcomes were highlighted suggesting their effectiveness. Several randomised, controlled trials and meta-analyses have proven the clinical and oncological safety of the laparoscopic gastrectomy for gastric cancer. Similarly, robot-assisted gastrectomy, EMR (endoscopic mucosal resection) and ESD (endoscopic sub-mucosal dissection) have also been proven feasible and safe to treat gastric cancer of various stages in prospective and retrospective comparative studies. However, UK based studies on minimally invasive surgery to treat gastric cancer is scarce and the paucity of trials led to uncertain outcomes. Laparoscopic gastrectomy, robot-assisted gastrectomy, EMR and ESD are feasible procedures in terms of clinical and oncological safety but mainly being practiced in Asian countries with high prevalence of stomach cancer. The UK based practice is still small and limited but the introduction of MIGOCS and STOMACH trial might help to widen the application of this technique.
机译:这项研究的目的是回顾文献并报告在英国用于治疗胃癌的各种微创方法,并将其与全球实践进行比较。从标准医学电子数据库中检索了已发表的随机研究,非随机研究和病例组,这些病例报告了使用微创方法治疗胃癌的方法,并突出显示了其结果,表明了其有效性。几项随机对照试验和荟萃分析证明了腹腔镜胃切除术治疗胃癌的临床和肿瘤学安全性。同样,在前瞻性和回顾性比较研究中,机器人辅助胃切除术,EMR(内窥镜黏膜切除术)和ESD(内窥镜黏膜下剥离术)也已被证明是可行且安全的。然而,基于英国的关于微创手术治疗胃癌的研究很少,并且缺乏试验导致不确定的结果。就临床和肿瘤学安全性而言,腹腔镜胃切除术,机器人辅助胃切除术,EMR和ESD是可行的方法,但主要在胃癌高发的亚洲国家/地区进行。以英国为基地的做法仍然很小且有限,但是引入MIGOCS和STOMACH试验可能有助于扩大该技术的应用范围。

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