Oncology Frontier: The oncologic safety and feasibility of laparoscopic D2 gastrectomy for advanced gastric cancer is still uncertain. Can a laparoscopic D2 gastrectomy be an optimal alternative to an open D2 gastrectomy? How can we optimize outcomes for these procedures?

 

　　《肿瘤瞭望》：晚期胃癌腹腔镜下D2根治术的安全性和可行性目前仍然是不确定的。腹腔镜下D2根治术能成为代替开放式D2根治术的最佳选择吗？我们如何才能优化这些手术的预后？

 

　　Dr Kanaya: There is no evidence for the use of laparoscopic D2 gastrectomy but I have been doing laparoscopic D2 gastrectomy for all gastric cancer patients so I feel I can perform D2 gastrectomy confidently. So although there is no trial evidence， my results have been very encouraging. There are only five surgeons， including myself， in Japan who do it. There is an RCT comparing laparoscopic to open surgery for advanced gastric cancer ongoing in Japan but right now there is no data.

 

　　Kanaya教授：腹腔镜下D2根治术的使用目前还没有明确的证据，但一直以来我为所有的胃癌患者都实行腹腔镜下D2根治术治疗，因此我对腹腔镜下D2根治术充满了信心。因此尽管目前没有试验依据，但我的研究结果已非常鼓舞人心。在日本，包括我在内仅有5名外科医生做这种手术。在日本有一个比较晚期胃癌腹腔镜手术治疗和开放式手术治疗的随机对照试验正在进行中，但目前还没有结果。

 

　　Oncology Frontier: A recent study showed that the long-term outcomes of laparoscopic subtotal gastrectomy are comparable to open surgery. Do you think these finding are of any clinical value?

 

　　《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仍有可比性，您认为这项发现对临床的应用有何意义？

 

　　Dr Kanaya: As the trials are still ongoing in Japan， there is no evidence for long-term outcomes. To date， I have found the outcomes in my own patients to be beneficial. Personally， I believe laparoscopic D2 gastrectomy is better than open surgery.

 

　　Kanaya教授：在日本这类研究仍在进行中，对长期结果的影响还没有明确的证据。目前为止，我在我自己的患者中证实了这种获益，。就我个人而言，我相信腹腔镜下D2根治术是优于开放式手术的。

 

　　Oncology Frontier: Radical resection for gastric cancer requires extensive lymph node dissection. Are there any differences between the laparoscopic surgery and traditional laparotomy with regard to the thoroughness of lymph node resection and recurrence rates?

 

　　《肿瘤瞭望》：胃癌根治术需要广泛淋巴结清扫，那么腹腔镜手术与传统开腹手术在关于淋巴结切除的彻底性和复发率方面是否存在差异性？

 

　　Dr Kanaya: Lymph node dissection for advanced gastric cancer is no different when comparing laparoscopic and open surgery. But I think the laparoscopic procedure has some advantages – we have a magnified view so can perform much finer lymph node dissection.

 

　　Dr Kanaya：晚期胃癌的淋巴结清扫在腹腔镜手术和开放式手术中没有差别。但我认为腹腔镜手术具有一定的优势：我们可以放大视野从而可以进行更加精细的淋巴结清扫。