Maffei Massimo, Dumonceau Jean-Marc
Division de gastroentérologie et d'hépatologie, HUG, 1211 Geneve 14.
Rev Med Suisse. 2008 Sep 3;4(169):1879-81.
In 2003, the first peroral appendectomy was carried out in a human subject. In order to prevent the premature adoption in clinical practice of the so-called "Natural orifice transluminal endoscopic surgery" (NOTES), a rational framework for its development was proposed in 2005. After animal experimentation, further abdominal interventions were carried out in humans (example: cholecystectomy) through the mouth, vagina, or in a combined approach. The main advantage of NOTES compared to laparoscopic surgery is, from the patient viewpoint, the absence of body scar, but other benefits (example: less pain and costs) could prove to be significant. It is impossible to predict whether or not NOTES will enter in routine clinical practice, but it will generate significant improvements for digestive endoscopy.
2003年,首例经口阑尾切除术在人体上实施。为防止所谓的“经自然腔道内镜手术”(NOTES)在临床实践中被过早采用,2005年提出了其合理的发展框架。经过动物实验后,通过口腔、阴道或联合途径在人体上进行了进一步的腹部手术(例如:胆囊切除术)。从患者角度来看,NOTES与腹腔镜手术相比的主要优势在于没有身体疤痕,但其他益处(例如:疼痛减轻和成本降低)可能也很显著。无法预测NOTES是否会进入常规临床实践,但它将为消化内镜检查带来显著改善。