胃食管结癌中腹腔镜的分期:系统性审查和元分析
Roberto de la Plaza Llamas1,2, Diego Ribera Díaz1, Paula Betancor Díaz1
1Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares 28871, Madrid, Spain.
World journal of gastrointestinal surgery
|February 16, 2026
概括
阶段性腹腔镜 (SL) 可以准确地识别转移性胃食道结 (GEJ) 癌症,将22%的患者升级阶段,避免不必要的手术. 这种诊断工具对Siewert II瘤特别有价值,可以改善治疗计划.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 阶段性腹腔镜 (SL) 检测胃食道结 (GEJ) 癌症的隐性转移,改善治疗计划.
- 先进的成像可能会错过低体积的腹膜疾病,强调需要SL的诊断性能 (DP).
- 在GEJ瘤中SL的实用性,特别是Siewert类型I和II,仍在争论中.
研究的目的:
- 评估分期腹腔镜 (SL) 在识别腹部转移性疾病的诊断性能 (DP).
- 评估SL在临床切除GEJ瘤患者中的作用.
主要方法:
- 按照PRISMA 2020指南进行系统审查和元分析.
- 在PubMed搜索到2024年3月29日,在GEJ瘤中对SL的研究.
- 主要结局:由于转移而升级到第四阶段的速度;次要结局:技术,患者特征,程序因素.
主要成果:
- 18项研究 (1591名患者) 显示,SL在22%的患者中升级到第四阶段.
- 综合的阳性率:腹膜恶性瘤 (17.5%),癌细胞 (13%),细胞学 (9%),肝转移 (9.2%).
- 在19.8%的病例中,SL避免了不必要的手术;在Siewert II中一致 (13%),在Siewert I中异质 (18%).
结论:
- 分期腹腔镜可提高GEJ癌症的分期精度,特别是Siewert II.
- SL有助于治疗决策,并防止无用的手术.
- 尽管数据异质,但SL是优化GEJ癌症管理的宝贵工具.
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