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结直肠癌外科治疗的最新进展

Recent updates in the surgical treatment of colorectal cancer.

作者信息

Matsuda Takeru, Yamashita Kimihiro, Hasegawa Hiroshi, Oshikiri Taro, Hosono Masayoshi, Higashino Nobuhide, Yamamoto Masashi, Matsuda Yoshiko, Kanaji Shingo, Nakamura Tetsu, Suzuki Satoshi, Sumi Yasuo, Kakeji Yoshihiro

机构信息

Division of Minimally Invasive Surgery Department of Surgery Kobe University Graduate School of Medicine Kobe Japan.

Division of Gastrointestinal Surgery Department of Surgery Kobe University Graduate School of Medicine Kobe Japan.

出版信息

Ann Gastroenterol Surg. 2018 Feb 15;2(2):129-136. doi: 10.1002/ags3.12061. eCollection 2018 Mar.

Abstract

Because of recent advances in medical technology and new findings of clinical trials, treatment options for colorectal cancer are evolutionally changing, even in the last few years. Therefore, we need to update the treatment options and strategies so that patients can receive optimal and tailored treatment. The present review aimed to elucidate the recent global trends and update the surgical treatment strategies in colorectal cancer by citing the literature published in the last 2 years, namely 2016 and 2017. Although laparoscopic surgery is still considered the most common approach for the treatment of colorectal cancer, new surgical technologies such as transanal total mesorectal excision, robotic surgery, and laparoscopic lateral pelvic lymph node dissection are emerging. However, with the recent evidence, superiority of the laparoscopic approach to the open approach for rectal cancer seems to be controversial. Surgeons should notice the risk of adverse outcomes associated with unfounded and uncontrolled use of these novel techniques. Many promising results are accumulating in preoperative and postoperative treatment including chemotherapy, chemoradiotherapy, and targeted therapy. Development of new biomarkers seems to be essential for further improvement in the treatment outcomes of colorectal cancer patients.

摘要

由于医学技术的最新进展以及临床试验的新发现,即使在过去几年中,结直肠癌的治疗选择也在不断演变。因此,我们需要更新治疗选择和策略,以便患者能够接受最佳的个性化治疗。本综述旨在通过引用2016年和2017年这过去两年发表的文献,阐明结直肠癌近期的全球趋势并更新其手术治疗策略。尽管腹腔镜手术仍然被认为是治疗结直肠癌最常用的方法,但诸如经肛门全直肠系膜切除术、机器人手术和腹腔镜侧方盆腔淋巴结清扫术等新的手术技术正在兴起。然而,根据最近的证据,腹腔镜手术相对于直肠癌开放手术的优越性似乎存在争议。外科医生应注意与无端和无节制使用这些新技术相关的不良后果风险。在包括化疗、放化疗和靶向治疗在内的术前和术后治疗中,许多有前景的结果正在积累。新生物标志物的开发似乎对于进一步改善结直肠癌患者的治疗结果至关重要。

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