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郑艺玲.超适应证早期胃癌的微创治疗：现状与展望——内镜黏膜下剥离术联合前哨淋巴结清扫术[J].内科急危重症杂志,2026,32(1):18-21
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| DOI：10.11768/nkjwzzzz20260104 |
| 中文关键词: 早期胃癌 内镜黏膜下剥离术 前哨淋巴结活检 |
| 英文关键词: |
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| 摘要点击次数: 65 |
| 全文下载次数: 65 |
| 中文摘要: |
| 摘要 早期胃癌的治疗已步入微创时代。内镜黏膜下剥离术（ESD）作为其首选治疗手段，适应证范围正不断拓展。然而，对于存在淋巴结转移风险的超适应证早期胃癌，如黏膜下深浸润（eCura-C2）等，传统外科根治术虽能有效清除淋巴结，却伴随着较高的手术创伤及并发症风险。近年来，ESD联合前哨淋巴结活检（SLNB）的治疗策略逐渐兴起，旨在实现肿瘤根治的同时，最大程度保留胃功能并提升患者生活质量。本文结合国内外最新研究进展及临床实践经验，系统评述ESD联合SLNB在超适应证早期胃癌中的应用现状、关键技术、存在问题及未来发展方向，以期为临床实践提供参考。 |
| 英文摘要: |
| Abstract The treatment of early gastric cancer has entered the era of minimally invasive techniques. Endoscopic submucosal dissection (ESD) has become the preferred treatment, with its indications continuously expanding. However, for expanded-indication early gastric cancer with risk of lymph node metastasis (e.g., deep submucosal invasion, eCura C-2), traditional surgical gastrectomy with lymph node dissection, while effective in clearing lymph nodes, is associated with significant surgical trauma and complication risks. In recent years, the strategy of combining ESD with sentinel lymph node biopsy (SLNB) has emerged, aiming to achieve oncological radicality while maximizing gastric function preservation and improving patients' quality of life. This article reviews the current application, key techniques, existing problems, and future directions of ESD combined with SLNB in expanded-indication early gastric cancer, based on the latest research progress and clinical practice experience, to provide references for clinical practice. |
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