《肿瘤瞭望》：最近一项研究发现腹腔镜下胃大部切除术与开放的胃大部切除术对胃癌患者的长期肿瘤学结局有可比性，对于该项研究您怎么评价，其对临床的应用又有何意义？

 

　　Dr Zilberstein: The laparoscopic procedure is now not new as it was first performed in 1990， so we already have 25 years of laparoscopic surgical experience. With the development of new techniques and new devices in laparoscopic surgery， in my opinion， laparoscopic surgery has become more reliable than open surgery. We have a better view; we can better dissect the small structures; and maybe we can provide a better operation. I strongly believe that. I would add that with the help of robotic procedures the skills of all surgeons will be enhanced and democratize surgery itself.

 

　　Dr Zilberstein：腹腔镜手术并不是一个新技术，自1990年首次开展以来，至今我们已有25年的腹腔镜外科手术的临床经验。在我看来，随着腹腔镜手术技术和设备的不断发展，腹腔镜手术相较于开放性手术而言更加安全可靠。我们则有一个更好的观点：（通过腹腔镜）我们可以更好地解剖体内的细微组织结构，甚至可以提供一个更优化的手术，我坚信这一定会实现。我还要补充一点，借助机器人操作可以大大提高所有外科医生的技能并且将使手术本身大众化。

 

　　Oncology Frontier: There are marked disparities between the East and the West in standard surgical procedures (D2 versus D1/0 lymphadenectomy) and their outcomes result in significant geographical variations in preferred adjuvant treatments. What is the situation in Brazil and what is your recommendation?

 

　　《肿瘤瞭望》：东西方在标准外科手术（D2 vs. D1/0淋巴结切除术）上存在着明显差异，这就导致首选的一线辅助治疗也存在显著的地域差异，在巴西这一情况如何？您对此有何评价？