Blackmore Alexander Emmanuel, Wong Mark Te Ching, Tang Choong Leong
Alexander Emmanuel Blackmore, Mark Te Ching Wong, Choong Leong Tang, Department of Colorectal Surgery, Singapore General Hospital, Singapore 169856, Singapore.
World J Gastroenterol. 2014 May 7;20(17):4926-33. doi: 10.3748/wjg.v20.i17.4926.
Open surgery for colorectal disease has progressed significantly over the past century from humble beginnings to form the mainstay of treatment for colorectal cancer and a number of benign conditions. Following the introduction of laparoscopic abdominal surgery, the next stage in the evolution of the specialty began in the 1990s with the first laparoscopic colonic resection. Following some early concerns regarding its safety and oncological efficacy during the latter part of that decade, laparoscopic colorectal surgery rapidly came into mainstream use in the early part of the current century with evidence supporting its use being made available from large scale randomised controlled trials. This article provides an evidence-based summary of this evolutionary process as it relates to both benign and malignant colorectal disease, as well as discussion of the next phase of new technologies such as robotic surgery.
在过去的一个世纪里,结直肠疾病的开放手术取得了显著进展,从最初的简陋起步发展成为结直肠癌及多种良性疾病治疗的主要手段。随着腹腔镜腹部手术的引入,该专业领域发展的下一阶段始于20世纪90年代的首例腹腔镜结肠切除术。在该十年后期,人们对其安全性和肿瘤学疗效曾有一些早期担忧,随后腹腔镜结直肠手术在本世纪初迅速成为主流术式,大规模随机对照试验提供的证据支持了其应用。本文基于循证医学对这一与结直肠良性和恶性疾病相关的发展过程进行了总结,并讨论了诸如机器人手术等新技术的下一阶段发展情况。