保功能胃切除术与生活质量。

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastric Cancer Pub Date : 2025-01-01 DOI:10.5230/jgc.2025.25.e7
Jeesun Kim, Hyuk-Joon Lee
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引用次数: 0

摘要

胃癌筛查的进步使早期发现成为可能,将治疗的重点转向保持患者的生活质量(QoL)。保功能胃切除术(FPG),包括保幽门胃切除术、近端胃切除术和前哨淋巴结导航手术,代表了早期胃癌手术治疗的范式转变。这些技术旨在平衡肿瘤安全性与胃功能的保存,减轻胃切除术后综合征,如倾倒综合征,胆汁反流和营养缺乏。生活质量评估工具,包括EORTC QLQ-STO22、koqus -40和PGSAS-45,已经成为评估患者报告结果的不可或缺的工具,提供了对身体、情绪和功能恢复的见解。尽管目前的证据强调了FPG的益处,但大多数研究仅限于东亚,这突出了在全球范围内验证这些发现的多国试验的必要性。FPG的短期和长期肿瘤预后与传统胃切除术相当。增强营养恢复和减少胃肠道后遗症使FPG越来越有吸引力。然而,它的广泛采用受到技术复杂性,资源强度和需要足够的手术经验的挑战。机器人手术和人工智能等先进技术的整合,加上个性化的方法,有望进一步优化FPG的结果。这篇综述强调了标准化的生活质量评估、合作研究和技术创新在推进FPG作为以患者为中心的胃癌治疗的基石方面的关键作用。
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Function Preserving Gastrectomy and Quality of Life.

Advances in gastric cancer screening have enabled earlier detection, shifting the focus of treatment toward preserving patients' quality of life (QoL). Function-preserving gastrectomy (FPG), including pylorus-preserving gastrectomy, proximal gastrectomy, and sentinel node navigation surgery, represents a paradigm shift in the surgical management of early gastric cancer. These techniques aim to balance oncological safety with the preservation of gastric function, mitigating postgastrectomy syndromes such as dumping syndrome, bile reflux, and nutritional deficiencies. QoL assessment tools, including EORTC QLQ-STO22, KOQUSS-40, and PGSAS-45, have become integral for evaluating patient-reported outcomes, providing insights into physical, emotional, and functional recovery. Although current evidence underscores the benefits of FPG, most studies are limited to East Asia, highlighting the need for multinational trials to validate these findings globally. FPG has demonstrated comparable short- and long-term oncological outcomes to conventional gastrectomy. Enhanced nutritional recovery and reduced gastrointestinal sequelae make FPG increasingly attractive. However, its widespread adoption is challenged by technical complexity, resource intensity, and the need for adequate surgical experience. The integration of advanced technologies, such as robotic surgery and artificial intelligence, coupled with personalized approaches, is expected to further optimize FPG outcomes. This review underscores the critical role of standardized QoL assessments, collaborative research, and technological innovations in advancing FPG as a cornerstone of patient-centered gastric cancer care.

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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
期刊最新文献
Function Preserving Gastrectomy and Quality of Life. Korean Gastric Cancer Association-Led Nationwide Survey on Surgically Treated Gastric Cancers in 2023. Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline). Management Strategy of Non-curative ESD in Gastric Cancer: Curative Criteria, and the Critical Building Block for Determining Beyond It. PD-L1 as a Biomarker in Gastric Cancer Immunotherapy.
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