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[机器人辅助直肠手术:炒作还是进步?]

[Robot-assisted rectal surgery: hype or progress?].

作者信息

Becker T, Egberts J E, Schafmayer C, Aselmann H

机构信息

Klinik für Allgemeine-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Str. 3, 24105, Kiel, Deutschland.

出版信息

Chirurg. 2016 Jul;87(7):567-72. doi: 10.1007/s00104-016-0220-3.

Abstract

Minimally invasive laparoscopic surgery for rectal cancer has undergone a significant evolution during the last decades and has become the standard approach in specialized centers with better short-term and comparable oncological outcome to open surgery. The laparoscopic approach remains challenging and has various inherent technical challenges particularly associated with rectal cancer resection. Robotic colorectal surgery using the da Vinci® surgical system has been successfully introduced into clinical practice during recent years and provides specific technical advantages. Studies have shown that the robotic approach in colorectal surgery is safe and feasible with comparable results. It is associated with low conversion rates, more R0 situations for low rectal cancer with larger tumors and more neoadjuvant treatment compared to standard laparoscopy. Robot-assisted surgery is an attractive development of minimally invasive surgery and should also be further evaluated with mandatory monitoring of outcome parameters in registries in Germany.

摘要

在过去几十年中,直肠癌的微创腹腔镜手术经历了重大发展,在专业中心已成为标准术式,其短期效果良好,肿瘤学结局与开放手术相当。腹腔镜手术仍具有挑战性,存在各种内在技术难题,尤其是与直肠癌切除术相关的问题。近年来,使用达芬奇®手术系统的机器人结直肠手术已成功应用于临床实践,并具有特定的技术优势。研究表明,结直肠手术中的机器人手术方法安全可行,结果相当。与标准腹腔镜手术相比,其转换率低,对于肿瘤较大的低位直肠癌,R0切除情况更多,新辅助治疗也更多。机器人辅助手术是微创手术的一项有吸引力的进展,在德国的登记处对结果参数进行强制监测的情况下,也应进一步评估。

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