对食道癌的最小侵入性食道切除术:目前的证据和未来的前景
Hirotaka Konishi1, Hiroyuki Inoue1, Hitoshi Fujiwara1
1Division of Digestive Surgery, Department of Surgery Kyoto Prefectural University of Medicine Kyoto Japan.
Annals of gastroenterological surgery
|March 9, 2026
概括
最少侵入性食道切除术 (MIE) 提供了一种对食道癌症治疗的不那么侵入性方法. 与开放式手术相比,胸腔镜,机器人辅助和中间体镜MIE在减少并发症和改善康复方面表现有前途.
科学领域:
- 在瘤学瘤学.
- 手术创新 在外科创新.
- 胃肠道手术 胃肠道手术
背景情况:
- 食道癌具有侵略性,亚型具有区域差异.
- 消化管切除术是主要的治愈治疗方法,微创性消化管切除术 (MIE) 越来越受欢迎,以减少侵入性.
- 多模式治疗的进步补充了手术方法.
研究的目的:
- 审查目前的最低侵入性食道切除术 (MIE) 技术的现状和结果.
- 为了比较不同的MIE方法,包括胸腔镜,机器人辅助和介质镜方法.
- 概述MIE在食道癌症治疗中的好处和局限性.
主要方法:
- 在2025年6月之前,使用PubMed/MEDLINE对MIE研究进行了全面的文献审查.
- 审查的重点是胸腔镜,机器人辅助和中间视镜食道切除术.
- 重点是随机试验和高质量的比较研究.
主要成果:
- 胸腔镜MIE,特别是在倾斜的位置,显示减少肺部并发症和比开放手术更快的恢复.
- 机器人辅助的MIE (RAMIE) 改善了淋巴结解剖和循环喉神经的保存.
- 介质视镜食管切除术是高风险患者的可行选择,肺部并发症减少,但需要进一步评估淋巴结解剖和神经损伤风险.
结论:
- 最少侵入性食道切除术 (MIE) 是一种不断发展的,不那么侵入性的食道癌开放性手术的替代方案.
- 需要进行标准化的多中心试验,以优化基于瘤和患者因素的MIE策略.
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