既往腹部手术对腹腔镜根治性手术胃癌患者短期结局的影响

The Impact of Previous Abdominal Surgery on Short-Term Outcomes of Gastric Cancer Patients Undergoing Laparoscopic Radical Surgery

摘要: 本文就既往腹部手术史(PAS)与腹腔镜胃癌(GC)手术后并发症相关性、短期结局以及当前治疗策略和研究进展进行总结。关于PSA和GC术后并发症的相关性，研究表明PAS不是影响术后并发症的独立危险因素。关于GC术后短期结局，大多数研究认为PAS组与非PAS组在术后短期结局(手术时间、出血量、术后住院时间及术后并发症)方面无显著差异，然而，也有研究指出，相较于非PAS组，PAS组的患者手术时间更长，且术后并发症发生率更高。尽管如此，经验丰富的外科医生通过在术前精准评估病情、术中熟练运用腹腔镜器械进行精细操作，以及术后合理使用防粘连材料，仍能够让PAS患者获得与无PAS患者相当的短期疗效。关于当前的治疗策略和研究进展，我们应在治疗的每个阶段采取更系统化、针对性的策略，以最大程度降低PSA对腹腔镜GC手术的影响，提高手术的安全性与可行性。

Abstract: This paper summarizes the correlation between a history of previous abdominal surgery (PAS) and postoperative complications of gastric cancer (GC) surgery, short-term outcomes, as well as current treatment strategies and research progress. Regarding the association between PAS and postoperative complications of GC surgery, studies have shown that PSA is not an independent risk factor for postoperative complications. In terms of short-term outcomes after GC surgery, most studies suggest that there are no significant differences between the PAS and non-PAS groups in operation time, bleeding volume, postoperative hospital stay, and postoperative complications. However, some studies have reported that, compared to the non-PAS group, patients in the PAS group tend to have longer operation times and a higher incidence of postoperative complications. Nevertheless, experienced surgeons can still help PAS patients achieve short-term outcomes comparable to those of non-PAS patients through precise preoperative assessment, skilled laparoscopic techniques, and the appropriate use of anti-adhesion materials postoperatively. Regarding current treatment strategies and research progress, a more systematic and targeted approach should be adopted at each stage of treatment to minimize the impact of PSA on laparoscopic GC surgery and enhance both the safety and feasibility of the procedure.