Kienle P, Weitz J, Koch M, Büchler M W
Department of Surgery, University of Heidelberg, Heidelberg, Germany.
Colorectal Dis. 2006 Sep;8 Suppl 3:33-6. doi: 10.1111/j.1463-1318.2006.01069.x.
Traditionally open surgical resection has been recommended for colorectal tumours, but recently, laparoscopic surgery has gained popularity. This review summarizes the published data on laparoscopic colorectal cancer surgery with emphasis on recently published trials. For colon cancer laparoscopic resection appears to be associated with the same outcome as open surgery. However, whilst short-term outcome was better in the laparoscopic group in most of the randomized trials, when comparing laparoscopic with fast-track open surgery, no differences could be demonstrated in a randomized control trial. For rectal cancer the data are less clear. It seems that it may be feasible to resect at least small rectal cancers laparoscopically. Clearly the role of the laparoscopic technique needs to be better defined in rectal cancer. It has been well documented that short- and long-term outcome of colorectal cancer surgery depends on the quality and experience of the team treating the patient. Therefore, the major future challenge in laparoscopic colorectal cancer surgery will be to provide and structure adequate training and introduce quality control measures.
传统上,对于结直肠肿瘤推荐采用开放性手术切除,但近年来,腹腔镜手术越来越受欢迎。本综述总结了已发表的关于腹腔镜结直肠癌手术的数据,重点关注最近发表的试验。对于结肠癌,腹腔镜切除似乎与开放性手术具有相同的疗效。然而,虽然在大多数随机试验中腹腔镜组的短期疗效更好,但在将腹腔镜手术与快速康复开放性手术进行比较时,一项随机对照试验未显示出差异。对于直肠癌,数据不太明确。似乎至少对小型直肠癌进行腹腔镜切除是可行的。显然,腹腔镜技术在直肠癌中的作用需要更好地界定。有充分记录表明,结直肠癌手术的短期和长期疗效取决于治疗患者团队的质量和经验。因此,腹腔镜结直肠癌手术未来的主要挑战将是提供并构建充分的培训,并引入质量控制措施。